Due to the increase in patients with multiple co-morbidities and immigration from developing countries the incidence of thoracic spondylodiscitis has not decreased. The diagnosis of thoracic spondylodiscitis is based on clinical findings, laboratory diagnostics and radiological imaging, including X-ray and MRI. Surgical therapy includes radical debridement, correction of deformity and adequate stabilisation, even though the use of titanium implants is discussed controversially. Additionally antibiotic therapy according to the resistance spectrum is necessary. Early diagnosis and therapy enable healing without severe complications.