Objective To explore the imaging findings characteristics of ankylosing spondylitis (AS) combined Andersson lesions (AL). Methods The clinical and imaging data of patients who diagnosed as AS combined AL at zhongshan hospital of Traditional Chinese Medicine between January 2012 and June 2017 were reviewed retrospectively. A total of 10 patients were with 11 lesions, including 9 cases of male and 2 cases of female. Age was from 36 to 79, the median age was 52. All the cases underwent X-ray examination, 8 cases underwent CT scan,6 cases underwent MRI plain scan and 3 cases underwent MRI enhanced scan, of which 3 cases underwent CT and MRI scan. Results 11 cases of lesions located in between T10 - S1, 1 case involved vertebral body, 10 cases involved intervertebral disc. 5 cases were separation AL, 4 cases were inflammatory AL, 2 cases were combined AL. X-ray diagnosis of 8 cases, 3 cases were misdiagnosed, including 2 of separation AL and 1 of inflammation AL. 8 case underwent CT scan, including 3 cases of separation AL, 2 cases of inflammatory AL and 1 case of combined AL. 4 cases of intervertebral disc showed vacuum sign; 1 case seed necrotic bone.6 cases underwent MRI, including 1 cases of separation AL and 5 cases of inflammatory AL, 2 cases of lesions showed mild edema around, 3 cases showed severe edema. 1 cases of vertebral side showed mass lesion. 3 cases showed ring enhancement which underwent MRI enhanced scan. Conclusion Ankylosing spondylitis more involve the intervertebral disc, vacuum sign help diagnosis of separation AL, inflammatory AL have little or no necrotic bone and soft tissue mass formation. X-ray for early AL are easily missed diagnosis, CT has good diagnosis effect for separation type AL, MRI has higher diagnosis accuracy for AL.