Introduction Drug therapy still remains the main stay in the treatment of TB spine. However, surgery is indicated in some patients. According to the MRC guidelines, radical ventral debridement, fusion, and the reconstruction of the spinal column remain the gold standard of surgical treatment for tuberculous spondylitis as popularized by Hodgson and his coworkers as the “Hong Kong” procedure. The lack of resources such as theater time, and the dual impact of HIV disease and TB pandemic led to the development of other surgical management techniques. Thus, the anterior debridement and anterior column reconstruction has evolved as a method of surgical intervention. The aim of this study is to report on the adequacy and outcome of patients treated with this surgical technique. Patients and Methods This is a retrospective study of 54 TB spine patients (25 males and 29 females) who had anterior decompression and interbody fusion over a 3-year period (from 2012 to 2014). The indications for surgery were essentially the same as for 360 degrees decompression and fusion. The average age of our patients was 38.6 years and the disease was thoracic in 49 cases and thoracolumbar in only 5 cases. Except for six cases of single vertebral body involvement, all of our cases have two contiguous vertebral bodies involvement and required a four-body fusion. In four cases, we used fibular strut graft, while the titanium mesh cage with a mixture of allograft and autograft (the cut rib) was used in majority of the cases. The mean follow-up period was 13 months (ranging from 6 to 30 months). Results The average preoperative kyphosis was 30 degrees; this improved to an average of 21 degrees postoperatively but falls to 27 degrees on the last follow-up (overall 10% improvement in the kyphosis angle). The mean Frankel neurology grading at the last follow-up was D (improvement from B to E). No loosening or breakage of implants occurs and no graft/mesh displacement recorded. Conclusion Early results of the anterior decompression and interbody fusion indicates that the method is adequate and the outcome gratifying. We therefore conclude that the procedure is an effective and adequate surgical technique for treating TB spine, but with possible risk of major complications.