Debridement used for spine tuberculosis has a long history. In 1934, Ito directly cut into the diseased region to clear the lesion to treat spine tuberculosis, and its efficacy was not ideal. From 1948 to 1951, antituberculosis drugs were successively used in clinics, and then “Hong Kong surgery” and “lesion removal therapy” proposed by Xianzhi Fang were appeared. After 2000, thorough debridement and minimally invasive concepts were used for spine tuberculosis. In recent years, spine endoscopy and transchannel surgery have been applied to treat spine tuberculosis. We will review the clinical application of different debridement in spine tuberculosis.