Spinal tuberculosis (TB) is a worldwide public health issue which is one of the main causes of disability. In regions with high TB incidence, Pott’s disease, also known as spinal tuberculosis, is also highly prevalent. Osteoarticular tuberculosis, which affects 1–2% of people with tuberculosis, is always a secondary infection that individuals with primary TB elsewhere in the body have. The most serious kind of bone TB is Pott’s paraplegia. The spinal cord is compressed, there is a gradual neurologic loss, and there may be deformity as the infection often starts from the vertebral body with noticeable damage and creation of a cold abscess. The management and treatment of spinal TB is challenging and intricate. Despite the availability of cutting-edge surgical techniques, imaging modalities, and anti-tubercular chemotherapy, managing Pott’s paraplegia can be challenging, particularly for those strains having multidrug resistant capacity. In order to achieve the desired neurological outcome, therapy should be tailored to each patient’s unique needs. Early diagnosis and prompt therapy are the main initial challenges in the management. The pathophysiology, imaging differential diagnosis, neuroimaging characteristics, surgical choice, and neurological prognosis of Pott’s paraplegia patients from previous literatures have been highlighted in this chapter.