Infections and secondary inflammatory changes play an important role in spine pathology leading to myelopathy or myelitis. To achieve optimal clinical outcomes and accurate prognosis, physicians must promptly recognize these disorders. This review provides a contemporary overview of the major pathogens known to cause myelopathic symptoms and focuses on unique clinical syndromes and signs to aid the differential diagnosis and further workup. This article will help neurologists to consider infectious etiologies during the initial evaluation of patients with myelopathic symptoms.