Background and Aims.Monocyte chemotactic protein-1 (MCP-1) gene polymorphisms play important roles in regulating immunological reactions and may be associated with pul-monary tuberculosis.However,the relationship between the MCP-1-2518 gene polymor-phism and susceptibility to spinal tuberculosis remains unknown.We undertook this study to investigate the relationships between MCP-1 promoter 2518 genotype frequency and allele polymorphisms and susceptibility to spinal tuberculosis in a Chinese Han population.Methods.Patients with spinal tuberculosis and healthy volunteers were enrolled between December 2004 and December 2010.MCP-1-2518 polymorphisms in both groups were detected using polymerase chain reaction and DNA sequencing.MCP-1 genotype was analyzed in all patients.Differences in genotype frequencies between groups were compared using x2 tests.Results.A total of 208 patients with spinal tuberculosis and 210 healthy volunteers were included.The distribution frequencies of MCP-1-2518 GG,GA and AA genotypes were 36.1,50.9 and 13.0%,respectively,in the case group and 25.2,53.8 and 21.0%,respec-tively,in the control group (p < 0.05).MCP-1-2518 GG genotype was significantly asso-ciated with the onset of spinal tuberculosis (OR =2.306,95% CI =1.273-4.178).The G and A allele frequencies were 61.5% and 38.5%,respectively,in the case group,and 52.1% and 47.9% in the control group (p <0.05),the allele "G" of MCP-1-2518 showed an association with an increased risk for spinal tuberculosis: OR =1.777,95% CI =1.053-2999,p =0.03 in the dominant model;OR =1.67,95% CI =1.097-2.544,p =0.016 in the recessive model.Conclusions.The MCP-1-2518 GG genotype and presence of the G allele may be asso-ciated with susceptibility to spinal tuberculosis in the Chinese Han population.