Abstract: OBJECTIVE To investigate the association of IFN-gamma gene polymorphism with susceptibility to spinal tuberculosis and serum of IL-4 and IFN-γ. METHODS Seventy-eight patients with spinal tuberculosis admitted to Hangzhou Red Cross Hospital hospital from Apr. 2016 to Sep. 2018 were selected as the spinal tuberculosis group, and 100 healthy volunteers as the control group. Polymerase chain reaction-restriction fragment length polymorphism（PCRRFLP） analysis was used to compare the gene polymorphism of IFN-γ rs2430561 locus between the two groups, and the serum IL-4 and IFN-γ levels in the two groups of subject were compared. RESULTS The frequencies of IFN-gamma rs2430561 A and T alleles were 88.46%（138/156） and 11.54%（18/156） in the patients with spinal tuberculosis, respectively, compared with 80.00%（160/200） and 20.00%（40/200） in the control group, with significant difference between the two groups（P＜0.05）. The serum IFN-gamma level in patients with spinal tuberculosis was（14.37±3.71） ng/L, significantly higher than that in control group（P＜0.001）, while there was no significant difference of IL-4 between the two groups（P=0.520）. The serum IFN-gamma level of AA genotype at IFN-gamma rs2430561 locus in spinal tuberculosis patients was（13.79±2.42） ng/L, significantly lower than that of AT+TT genotype（P=0.025）, while there was no significant difference of serum IL-4 among different genotypes. CONCLUSION The polymorphism of IFN-γ rs2430561 locus is closely related to the susceptibility of spinal tuberculosis. As a susceptibility gene of spinal tuberculosis, the A allele polymorphism of IFN-γ locus could affect the expression of IFN-γ in host and play a role in regulating and protecting tuberculosis immunity.