Our aim was to compare the clinical and evaluative features of a series of cases with spondylitis of the 2 most frequent etiologies, brucellosis and tuberculosis, in Turkey.Of the 87 patients with spondylitis, 44 had brucellosis and 43 had tuberculosis. Patients with tuberculosis were more likely to have a history of pulmonary disease, longer time to diagnosis, and higher erythrocyte sedimentation rates and C-reactive protein levels. Fever, night sweating, and arthralgia were more frequent complaints in brucellosis, whereas weakness and neurological involvement were in tuberculous spondylitis. Vertebral destruction and compression, kyphosis, paraspinal masses, and cord compression were more frequent in tuberculosis. Sacroiliitis and discitis were significantly associated with brucellosis. Need for surgical treatment, unfavorable outcome, and death were more common in tuberculosis.In countries with high prevalence of both diseases, documented history, clinical presentation, laboratory and histological examination, and radiographic imaging can be highly suggestive and sufficient for empirical treatment. © 2008 Lippincott Williams & Wilkins, Inc.