Patients who present with apparent kyphotic deformity of the spine associated with ankylosing spondylitis may have their main deformity in the hip joints, in the lumbar spine, the thoracic spine, or it may be primarily cervical in situation. If any major correction is to be carried out, then the correction should be done in the area of the main deformity. Deformity in each of these areas is amenable to surgical correction, but this requires a very careful assessment, meticulous preoperative planning, and very precise attention to operative technique to allow reasonably consistent success without major risk to the patient.