Objective: To investigate the correlation between prognosis of spinal metastatic cancer and the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Methods: The expressions of MMPs and TIMPs were quantitatively studied by immunohistochemical method and image analysis technique in 77 patients with spinal metastatic cancer. The relation between MMPs and TIMPs expression and patients' prognosis was analyzed using Cox regression model. Results: The 3-year postoperative survival rate of the patients was 6.98% after a mean follow-up of 15.60?8.45 months ( 5.2-36 months). Both MMPs and TIMPs expressed in cancer cells and mesenchyme. The expression of MMP-2, TIMP-1 and TIMP-2 was the highest in the metastatic tumor from lung cancer (P