Spinal fungal infections are rare and usually occur in immunocompromised individuals, most commonly developing in the lumbar region. They often manifest as aspergillosis and invasive candidiasis. The most frequent causative agent among Aspergillus species is Aspergillus fumigatus (55%), while Candida albicans (62%) is the most common cause of spinal candidiasis. Initial symptoms of spinal fungal infections are typically nonspecific; back pain, fever, and night sweats are significant symptoms. Neurological deficits are observed in an average of 36.5% of cases. Diagnosis involves the use of radiological imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). Imaging may reveal involvement, preservation of disk and disk space, the affected posterior elements of the vertebra, paraspinal small abscesses, frequent anterior subligamentous spread, and skip lesions, especially in the lumbar region. Confirmation of the diagnosis is achieved through biopsy, with direct microscopy, histopathology, culture, or polymerase chain reaction (excluding endemic mycoses) used to identify the causative agent. Galactomannan antigen detection in serum, bronchoalveolar lavage, and cerebrospinal fluid, especially for Aspergillus spp., and serum (1,3)-β-D-glucan testing for various mycoses, including Aspergillus spp. and Candida spp., can be utilized for diagnosis. Voriconazole is the preferred antifungal for treatment against Aspergillus species. Liposomal amphotericin B can be used as an alternative or in combination, and echinocandins, posaconazole, and itraconazole are recommended as salvage therapies in cases of unresponsive infections. Treatment is usually recommended for a minimum of 8 weeks. For vertebral osteomyelitis caused by Candida spp., treatment may extend beyond 12 months (minimum of 6 months). Surgical indications for spinal fungal infections include resistance to antifungal therapy, failure of conservative treatment despite months of antifungal therapy, compression of the spinal cord and/or roots, development of neurological deficits, spinal instability, and/or deformity, the necessity of debridement to eliminate the infection burden, and failure to identify the causative organism in blood cultures, serology, and needle biopsy.