Background: Ankylosing spondylitis (AS) affects men more than women and commonly results in chronic back pain with spine and sacroiliac joint involvement. Case Report: The patient is a 53-year-old man with a 25-year history of worsening AS. After not responding to available conservative therapies and not qualifying for back surgery, the patient underwent a 10-kHz high-frequency spinal cord stimulation (HF10 SCS) trial. After a successful trial without complications, permanent implantation was pursued with subsequent one-week postoperative outcomes demonstrating Visual Analog Scale score reductions of 87.5% in back pain and 50% in leg pain, an Oswestry Disability Index score decrease of 83%, and overall improvement in previously problematic health concepts on the EuroQol-5 Dimensions-3 Levels and 36-Item Short Form version 2 surveys. Conclusions: This report highlights the successful use of Senza’s SCS system applying Nevro’s HF10 therapy in a patient with refractory symptoms of AS, highlighting potential applications of this technique which have yet to be studied. Key words: Ankylosing spondylitis, high-frequency spinal cord stimulation, chronic pain, back pain, case report