SSI after spine surgery is a challenging problem with a major toll on the patient, the surgeon, and the healthcare national system. Infection is a major complication both in short and long term due to being challenging to diagnose, and even more to treat. It often requires prolonged medical therapy and sometimes more than one surgical debridement. Many factors play a role in deter­mining the risk of SSI, both changeable or unchangeable; the surgeon should look to mini­mize the risk of postoperative infection by taking action on the changeable elements. A strict fol­low- up in the post-operative short and long time period is mandatory. SSI should be investigated every time there is an anomalous postoperative course, using blood exams and radiological exams; an early diagnosis is the key to success. Once diagnosed, a treatment strategy can be dened. It is advised to obtain blood cultures and local tissue samplings to identify the pathogenic agent responsible for the infection; broad­spectrum IV antibiotics are mandatory until results are obtained, and it is possible to switch to a more specic antibiotic. Treatment can change based on the patient’s clinical history, the site of infection (supercial or deep), the postoperative infection timing (early or late), and the type of surgery (presence or absence of spine implant), but it is usually based on long-term antibiotic and local surgical debridement. Implant removal is usually avoided but can be necessary in difcult cases when neurological symptoms are present.