Surgical site infections (SSIs) after spinal surgery are an important cause of postoperative morbidity and a multidisciplinary approach should focus on prevention. Screening for preoperative and recognition of intraoperative risk factors that increase the incidence of SSIs should be routine practice. Factors shown to influence SSIs include diabetes, obesity, previous SSI, complex multilevel procedures, and excessive surgical time and blood loss. Multidisciplinary awareness and monitoring for SSIs is required with a high index of suspicion based on a combination of clinical findings including pain in the surgical area, swelling, fever, and wound discharge and diagnostic tests including WCC, CRP, ESR, wound microbiology, and blood cultures. Imaging the area with ultrasound, CT, or MRI and guided needle sampling of any detected collections may be required. Prompt treatment with antibiotics reflecting regional bacterial isolates and their sensitivity patterns should be implemented. Surgical wound wash outs, often performed repeatedly, may be necessary in selected cases.