There is a noted rise in the incidence of spontaneous spondylodiscitis per year and this is probably because of the increased aging population, rising incidence of immunodeficiency and better radiological technique that helps diagnosis the disease earlier. Aim of Study: To compare the results of both surgical treatment and conservative management of spontaneous spondylodiscitis in the light of clinical outcome, radiological outcomes, and complications. Patients and Methods: This is a prospective randomized clinical trial study including 32 patients diagnosed clinically, radiologically, laboratory with spontaneous spondylodiscitis either cervical, dorsal or lumbar. They were divided into 2 groups: One treated conservatively and the other surgically. Results: 16 patients were treated conservatively and 16 were managed surgically. After complete course of treatment; only 10 patients of conservative group and 13 patients of surgical group showed fusion assessed by imaging. There was no significant statistically difference between two groups in final clinical outcome using visual analogue scale and MacNab's outcome criteria. Conclusion: Both conservative and surgical methods are nearly equivalent in reaching the aims of management of spontaneous spondylodiscitis because they are safe, achievable, and effective procedures in treating the pain caused by the disease