Ankylosing spondylitis is a chronic inflammatory disease with young age onset which after years of duration leads to spinal stiffness, loss of function, disability, as well as a considerable percentage of work-incapacitated patients. The efficacy of a new group of drugs – TNF blockers – has been confirmed in many randomized clinical trials, the results of which have published over the last several years. The introduction of TNF blockers has caused a revolution in rheumatology. International groups of experts and scientific rheumatology societies from different countries, including Poland, have published treatment guidelines, which are regularly revised and updated. This article analyzes similarities and differences between ASAS, British, French, Canadian and Polish recommendations for the management of ankylosing spondylitis as well as prescribing and monitoring of TNF-α antagonist therapy.