The ASAS/EULAR 2010 update of recommendations for the management of ankylosing spondylitis (AS) was developed through a systematic review of existing literature and expert consensus. The update involved 21 international experts, 2 patients, and 2 physiotherapists, and included 11 bullet points, two of which were new. The recommendations apply to all patients meeting the modified New York criteria for AS, regardless of extra-articular manifestations. Four overarching principles were introduced, including the importance of multidisciplinary treatment and shared decision-making between patients and rheumatologists. The recommendations emphasize the need for individualized treatment based on disease manifestations, symptom severity, and clinical status. Non-pharmacological treatments, such as patient education and exercise, are highlighted as essential. Pharmacological treatments include non-steroidal anti-inflammatory drugs (NSAIDs) as first-line therapy, with consideration of cardiovascular, gastrointestinal, and renal risks. Anti-TNF therapy is recommended for patients with persistent disease activity, and there is no evidence supporting the use of other biological agents in AS. The recommendations also address extra-articular manifestations, comorbidities, and surgical interventions. The update reflects the evolving understanding of AS and its relationship with axial spondyloarthritis. The strength of recommendations was scored on an 11-point scale, with a mean score of 9.1. The recommendations were evaluated and disseminated in several countries, and a patient version was developed. The update was based on extensive literature review and expert discussions, and it aims to improve the management of AS by incorporating the latest evidence and patient perspectives. The recommendations emphasize the importance of early diagnosis, individualized treatment, and multidisciplinary care. The update also highlights the need for further research on the long-term safety and efficacy of treatments in AS.The ASAS/EULAR 2010 update of recommendations for the management of ankylosing spondylitis (AS) was developed through a systematic review of existing literature and expert consensus. The update involved 21 international experts, 2 patients, and 2 physiotherapists, and included 11 bullet points, two of which were new. The recommendations apply to all patients meeting the modified New York criteria for AS, regardless of extra-articular manifestations. Four overarching principles were introduced, including the importance of multidisciplinary treatment and shared decision-making between patients and rheumatologists. The recommendations emphasize the need for individualized treatment based on disease manifestations, symptom severity, and clinical status. Non-pharmacological treatments, such as patient education and exercise, are highlighted as essential. Pharmacological treatments include non-steroidal anti-inflammatory drugs (NSAIDs) as first-line therapy, with consideration of cardiovascular, gastrointestinal, and renal risks. Anti-TNF therapy is recommended for patients with persistent disease activity, and there is no evidence supporting the use of other biological agents in AS. The recommendations also address extra-articular manifestations, comorbidities, and surgical interventions. The update reflects the evolving understanding of AS and its relationship with axial spondyloarthritis. The strength of recommendations was scored on an 11-point scale, with a mean score of 9.1. The recommendations were evaluated and disseminated in several countries, and a patient version was developed. The update was based on extensive literature review and expert discussions, and it aims to improve the management of AS by incorporating the latest evidence and patient perspectives. The recommendations emphasize the importance of early diagnosis, individualized treatment, and multidisciplinary care. The update also highlights the need for further research on the long-term safety and efficacy of treatments in AS.