Objective: To study the diagnosis and surgical treatment of thoracic-lumbar Andersson lesions among patients with ankylosing spondylitis. Method: We retrospectively collected data from all patients with spine Andersson lesions from 2010 to 2020 and follow-up patients who received surgical treatment. One of the patients was misdiagnosed as spinal tuberculosis but was diagnosed with Andersson lesion after reviewing the patient’s postoperative data. Results: There were 11 patients with Andersson lesions, three females and eight males. Four patients received conservative treatment, and six patients received posterior long-segment pedicle screw fixation, one patient received anterior lumbar fusion. One patient occurred neurologic impairment. All other patients recovered well and spine pain disappeared. There was no surgical infection. Conclusion: Andersson lesions among patients with ankylosing spondylitis could be treated with posterior long-segment pedicle screw fixation. And it should be differentiated between spine infection and spine tuberculosis.