Spondyloarthropathy defines a group of diseases characterized by chronic inflammation of axial or peripheral joints with a variety of mucocutaneous, ophthalmic lesions. Evidence showed that these disorders are autoimmune in origin with T cells, B cells and monocytes/macrophages playing major roles. In addition, cytokines secreted by these immune cells also were considered indispensible to the triggering of these diseases. Before the era of biological agents, non-steroidal anti-inflammatory drugs (NSAIDS) were only drugs proved to be useful in treating patients with spondyloarthropathy. None of disease-modifying anti-rheumatic drugs (DMARDS) were considered effective in modification of disease course, especially in axial symptom. Thanks to the invention of biological agents, both clinical and radiological parameters were found to improve after targeting therapy. The efficacy of tumor necrosis factor blockage in patients with spondyloarthropathy is almost as effective as in patients with rheumatoid arthritis. New insight of pathogenesis uncovered novel molecules involved, which were potential targets in the future.