Objective To analyze the clinical outcomes of one-stage anterior debridement, dura splitting decompression, one-stage kyphosis correction, bone grafting and internal fixation in the treatment of thoracolumbar tuberculosis. Methods Clinical data of 32 cases with thoracolumbar tuberculosis who underwent above surgeries in our hospital from January 2007 to January 2015 were collected retrospectively. The time of bone graft fusion, and the changes of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), kyphotic angle (Cobb angle) and American Spine Injury Association (ASIA) grade before and after treatment were collected and analyzed. Results The average operation time was (177.3±14.5)min, and the mean amount of intraoperative blood loss was (492.5±170.1)ml. During the postoperative follow-up of (36.9±12.7)months (ranging from 18 to 72 months), no recurrence of thoracolumbar tuberculosis was found in all the patients. The time of bone graft fusion was (5.5±1.1)months (3-8 months). The levels of ESR and CRP were gradually declined to normal levels at 3 months after operation. Their ASIA grades also went back to normal at the last follow-up. The average angle of kyphosis was decreased from (17.6°±6.4°) preoperatively to (2.5°±1.3°) post-operatively, and then to (3.8°±1.5°) at the last follow-up. No significant loss of correction angle (1.3°±0.6°) was observed, but the angle was greatly improved postoperatively and at the last follow-up when compared with that before operation (P<0. 5). At the last follow-up, all patients got solid bony fusion and had no evidences of internal fixation and fracture. Conclusion Anterior operation is suitable to one-stage anterior debridement, dura splitting decompression, one-stage kyphosis correction, bone grafting and internal fixation and reconstruction of spinal stability for thoracolumbar tuberculosis, with satisfying clinical outcomes.