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Pathogenesis of spondyloarthritis (SpA) is multifactorial and still not understood entirely. The role of genetics including human leukocyte antigen B27 has been investigated extensively, which along with genome-wide association studies has helped us understand and postulate various theories. Environmental factors including gut dysbiosis, mechanical stress, and transduction have been implicated in the pathogenesis. Recently, the interleukin (IL)-17/IL-23 pathway has been major focus due to it being therapeutic target. Herein, we reviewed various recent developments and current concepts in the pathogenesis of SpA.