Tuberculosis of Spine and conus medullaris syndrome 65 year old male had sudden onset back pain with severe radiation in legs along with weakness in both lower limbs. His MRI showed pathological fracture of D 12 vertebra with soft tissue mass compressing on the spinal cord. He underwent decompression and fixation after 2 days. In post operative period he showed some improvement. he completely recovered bladder and bowel control in 6 months. Biopsy sent during surgery was suggestive of tuberculosis. Anti tubercular medicine was given for 9 months.