Pyogenic spinal infections are potentially life-threatening diseases that can impair the patient’s neurological status, physical abilities, and quality of life. They can be considered a single disease or group of diseases and include spondylitis, discitis, facet arthritis, epidural phlegmon/abscesses, peri/paraspinal soft tissue infection/abscesses, pachymeningitis and/or leptomeningitis, and myelitis/spinal cord abscess. This group of diseases is distinct from degenerative diseases, metabolic and inflammatory disorders, and neoplasms and mimickers. Delays in the diagnosis and treatment can cause significant morbidity and mor-tality. Imaging is important in preparing diagnoses, planning minimally invasive treatment, and monitoring patient progress. This review explains the adult spinal infections’ radiological imaging features and their values in differential diagnoses.