Tracheoesophageal fistula(TEF) following anterior cervical spine surgery has rarely been reported in literature. We present the challenges in the diagnosis and management of a case of TEF complicating a cervicodorsal spine surgery for tuberculous spondylodiscitis of the cervicothoracic junction and its resourceful management. A 23-year-old female with D2-D3 tuberculous spondylodiscitis with neurodeficit(ASIA C) was managed with C6 to D5 posterior instrumented stabilization followed by anterior debridement and reconstruction with clavicle autograft through a medial clavicle resecting approach. From the fourth postoperative day onwards, the patient developed recalcitrant cough following oral intake,dysphagia,and hoarseness of voice. A computed tomography(CT) of chest, oesophagoscopy, and bronchoscopy revealed a TEF situated 18cm distal to the pharyngeal opening. To prevent aspiration of feeds and pneumonitis the patient was managed with a feeding jejunostomy and kept on total parenteral nutrition, for 5 months. Patient was gradually transitioned from Ryle’s tube feeding to oral feeds. After 9 months of antitubercular chemotherapy, a CT scan of the thorax, oesophagoscopy and bronchoscopy revealed complete healing of the fistula.At the end of chemotherapy, plain radiographs and CT scan revealed complete healing of the lesion with complete neurological recovery. A high index of clinical suspicion of TEF is essential in any patient with cough and dysphagia after an anterior approach to the cervicodorsal junction. A meticulous multidisciplinary approach is mandatory to diagnose and manage this condition. An undiagnosed TEF can lead to fatal complications like pneumonia, mediastinitis and ARDS.