To date, there are no standardized treatment algorithms or recommendations for patients with infective endocarditis (IE) and concomitant spondylodiscitis (SD). Therefore, our aim was to analyze whether the sequence of surgical treatment of IE and SD has an impact on postoperative outcome and to identify risk factors for survival and postoperative recurrence. Patients with IE underwent surgery in 4 German university hospitals between 1994 and 2022. Univariable and multivariable analyses were performed to identify possible predictors of 30-day/1-year mortality and recurrence of IE and/or SD. From the total IE cohort (n = 3991), 150 patients (4.4%) had concomitant SD. Primary surgery for IE was performed in 76.6%, and primary surgery for SD in 23.3%. The median age was 70.0 [64.0-75.6] years and patients were mostly male (79.5%). The most common pathogens detected were enterococci and Staphylococcus aureus followed by streptococci, and Coagulase Negative Staphylococci (CoNS). If SD was operated on first, 30-day mortality was significantly higher than if IE was operated on first (25.7% vs 11.4%; p = 0.037) and we observed a tendency for a higher 1-year mortality. If IE was treated first, we observed a higher recurrence rate within one year (12.2% vs 0%; p = 0.023). Multivariable analysis showed that primary surgery for SD was an independent predictor of 30-day mortality. Primary surgical treatment for SD was an independent risk factor for 30-day mortality. When IE was treated surgically first, recurrence rate of IE and/or SD was higher.