The birth defects include Congenital anomalies of the spine which is pretty common in India especially associated to poor nutrition. It can affect any part of the spine from cranio-vertebral junction (neck) to lumbo-sacral spine (lower back). The examples are Meningomyelocele (MMC), basilar invagination and AAD, scoliosis and spinal tumors (dermoid). All congenital disorders usually present with deformity or neurological deficits and they usually do not cause any pain. These are diagnosed with the help of CT scan and MR imaging. The complexity of congenital anomalies of the spine can become challenging for diagnosis as well as treatment.