[Objective] To introduce the technique and early curative effect of one stage posterior debridement, intervertebral fusion and internal fixation for upper thoracic tuberculosis. [Methods] Eight patients with upper thoracic tuberculosis were treated with one-stage posterior debridement, intervertebral fusion and internal fixation. The posterior midline incision was made, and the lateral range of exposure included the bilateral costotransverse articulations and partial ribs. Costotransversectomy and removal of the articular process, pedicle, and transverse process on the more severely affected side of the lesion segment was performed to drain paravertebral abscesses and expose diseased vertebral bodies. Necrotic tissue was curetted as thoroughly as possible. The kyphotic deformity was corrected after thorough debridement and spinal canal decompression. The intervertebral defect was then measured and the gap was repaired with a suitable length of autologous bone graft harvested from the ilium and ribs. [Results] All the 8 patients successfully accepted the surgery, VAS, ODI score, ESR and CRP were significantly improved 3 months after the surgery and at the final follow-up (P < 0.05). At the final follow-up, the function of the lower extremity in 5 patients with paraplegia completely returned to normal, the kyphotic orthosis rate was (71.5±7.3) %, and the mean loss angle was (3.5±1.4) °. All patients achieved intervertebral bone fusion. [Conclusions] One-stage posterior debridement, intervertebral fusion and internal fixation in the treatment of upper thoracic tuberculosis are relatively simple, less traumatic and effective.