The 2016 ASAS-EULAR management recommendations for axial spondyloarthritis (axSpA) provide updated guidance for the treatment of patients with axSpA. The recommendations integrate the management of ankylosing spondylitis (AS) and the use of tumour necrosis factor inhibitors (TNFi) in axSpA into a single set of guidelines applicable to the full spectrum of axSpA patients. The recommendations are based on systematic literature reviews of all treatment options (pharmacological and non-pharmacological) published since 2009. After discussion and consensus, five overarching principles and 13 recommendations were agreed upon. The first three recommendations focus on personalised medicine, including treatment targets and monitoring. Recommendation 4 covers non-pharmacological management, while recommendation 5 highlights the central role of non-steroidal anti-inflammatory drugs (NSAIDs) as first-line treatment. Recommendations 6–8 define the modest role of analgesics and disprove the use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in axSpA. Recommendation 9 refers to biological DMARDs (bDMARDs), including TNFi and IL-17 inhibitors, for patients with high disease activity despite the use of at least two NSAIDs. Recommendations 10–13 address the use of bDMARDs, including switching to another TNFi or IL-17i if TNFi fails, tapering bDMARDs in sustained remission, and surgery and spinal fractures. The recommendations emphasize the importance of shared decision-making between patients and rheumatologists, and consider the individual, medical, and societal costs of axSpA in treatment decisions. The recommendations also highlight the importance of non-pharmacological management, including exercise, physical therapy, and smoking cessation. The recommendations are based on a thorough evaluation of the evidence, including the level of evidence (LoE) and grade of recommendation (GoR), and are intended to guide the management of axSpA patients in clinical practice.The 2016 ASAS-EULAR management recommendations for axial spondyloarthritis (axSpA) provide updated guidance for the treatment of patients with axSpA. The recommendations integrate the management of ankylosing spondylitis (AS) and the use of tumour necrosis factor inhibitors (TNFi) in axSpA into a single set of guidelines applicable to the full spectrum of axSpA patients. The recommendations are based on systematic literature reviews of all treatment options (pharmacological and non-pharmacological) published since 2009. After discussion and consensus, five overarching principles and 13 recommendations were agreed upon. The first three recommendations focus on personalised medicine, including treatment targets and monitoring. Recommendation 4 covers non-pharmacological management, while recommendation 5 highlights the central role of non-steroidal anti-inflammatory drugs (NSAIDs) as first-line treatment. Recommendations 6–8 define the modest role of analgesics and disprove the use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in axSpA. Recommendation 9 refers to biological DMARDs (bDMARDs), including TNFi and IL-17 inhibitors, for patients with high disease activity despite the use of at least two NSAIDs. Recommendations 10–13 address the use of bDMARDs, including switching to another TNFi or IL-17i if TNFi fails, tapering bDMARDs in sustained remission, and surgery and spinal fractures. The recommendations emphasize the importance of shared decision-making between patients and rheumatologists, and consider the individual, medical, and societal costs of axSpA in treatment decisions. The recommendations also highlight the importance of non-pharmacological management, including exercise, physical therapy, and smoking cessation. The recommendations are based on a thorough evaluation of the evidence, including the level of evidence (LoE) and grade of recommendation (GoR), and are intended to guide the management of axSpA patients in clinical practice.