Objective To analyze and discuss the different characteristics of clinical imaging of Brucellar and tuberculous spondylitis,and to improve the diagnostic performance of the image of Brucellar spondylitis.Methods A retrospective analysis at Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University was conducted from January 2011 to December 2013.X-ray,computer tomography (CT)and magnetic resonance imaging (MRI)data of 46 cases of Brucellar spondylitis and 40 cases of tuberculous spondylitis were compared.Results The lumbar spine,especially L4,was usually involved in brucellosis,characterized with multiple small lesions mostly confined to the edge of vertebral body and surrounded by the hyperplasia and sclerosis.New damaged foci were formed in the new bone tissue and intervertebral discs destruction was slight with hyperplasia and sclerosis of articular surface. Few or no paravertebral abscesses were seen.In contrast,thoracic and lumbar spines were more usually affected in tuberculosis featured with destruction of vertebra and intervertebral discs.There could be dead bone formation.Paravertebral abscesses and osteoporosis were frequent.Conclusion The different imaging characteristics of Brucellar and tuberculous spondylitis could favor the differential diagnosis.