Abstract: Spinal infection (SI) is a disease caused by pathogenic bacteria spreading along the axial skeleton. Although MRI is the first imaging examination method for SI diagnosis, it has some disadvantages in diagnosis and differential diagnosis of SI. And ¹⁸F-FDG PET/CT, as one-stop general check-up method, is superior to MRI in identifying specific primary lesion and postoperative infection, and evaluating treatment response. The review mainly includes the clinical application of ¹⁸F-FDG PET/CT in early diagnosis, differential diagnosis and therapeutic efficacy evaluation of SI and compares it with MRI.