Axial spondyloarthritis（axSpA）includes ankylosing spondylitis（AS）and non-radiographic spondyloarthritis（nr-axSpA）. nr-axSpA is a disease concept proposed as a pre-radiographic stage of AS, but not all of them progress to AS. The main symptom of axSpA is chronic, young-onset inflammatory back pain. Peripheral symptoms are associated with peripheral arthritis and enthesitis in 30% to 50% of patients. Extra-articular lesions include uveitis, inflammatory bowel disease, and psoriasis etc. Other information such as CRP/ESR, HLA-B27, family history of SpA, and good response to NSAIDs are also helpful for diagnosis. First line of pharmacological therapy is NSAID, and b/tsDMARD are positioned as second line. But if the response is not appropriate, diagnosis, comorbidity and adherence should be re-evaluated.