The conventional approach to treatment of patients with ankylosing spondylitis (AS) have been rather limited in the last decades. Evidence is accumulating that tumor necrosis factor (TNF) blocker is highly effective in AS. This article reviews the most recent and the most pertinent advances in the treatment in AS. TNF blocker have been evaluated in a number of randomized controlled trials in AS and have been demonstrated to be effective in disease activity, function, and quality of life in these patients. TNF blocker is emerging as the best therapeutic option available for patients with AS.