Introduction: Spinal tuberculosis a type of extrapulmonary TB, is a common occurrence. Despite its widespread incidence and high rate of long-term morbidity, there are no clear diagnostic or treatment criteria for spinal TB. To avoid permanent neurological dysfunction and to limit spinal deformity, early diagnosis and treatment are essential. Materials & Methods: A total of 24 patients were selected patients with clinico-radiological features suggestive of tubercular spondylo discitis and meeting the inclusion and exclusion criterion were taken into study. A transpedicular biopsy was done in the operation theatre under all aseptic precautions under fluoroscopy guidance. The sample collected was sent for further analysis for histopathology, AFB stain for TB, Gram stain, CBNAAT/Line Probe Assay to the respective departments for further evaluation. Results: Adequate amount of sample was obtained in 22 of the 24 cases. Out of the 24 patients biopsy was positive for tuberculosis in 75% of cases, suggestive of metastasis in 2 cases and 2 sample suggestive non specific chronic granulomatous lesion. Statistically, MRI was not specific to tuberculosis in the cases with most cases suggestive of end plate erosion and paravertebral collection. This study has tried to validate different diagnostic procedures which showed spinal infections with large abscess with thin wall, subligamentous spread of abscess and vertebral collapse were highly suggestive of spinal tuberculosis. Conclusion: In the present study using this method we could identify 25% non-tubercular pathologies which mimic TB spine clinic-radiologically and avoided the additional misery of the patients. Percutaneous transpedicular biopsy of spine under fluoroscopic guidance is a safe, rapid, reliable, sensitive and feasible method of obtaining tissue or pus sample for confirmatory diagnosis of suspected spinal tubercular lesion. The study needs evaluation over larger sample size to find the difference between significance of Clinical, Radiological and histopathological findings.