The aim of the study was to evaluate factors that influence health status and work disability in patients with ankylosing spondylitis (AS) in the Czech Republic. Data were collected in a retrospective fashion directly from patients with AS using mailed questionnaires containing questions regarding sociodemographic characteristics of patients, the course of their disease, therapy, rehabilitation, quality of life, and ability to work. HAQ-DI (Health Assessment Questionnaire-Disability Index) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) were also included in the questionnaires; 1,008 questionnaires were suitable for further statistical analysis. The average age of patients was 50.2 years, the average symptom duration was 23.0 years. Mean time from first symptoms to diagnosis was 9.1 years. Receiving disability pension was more frequent among men (64%) compared to women (56%) (P=0.012), despite the fact that women had higher BASDAI (P<0.001) and HAQ-DI (P=0.004) scores. Fifty eight percent of patients reported a BASDAI score more than 4 (current cutoff value for initiation of biological therapy), but only 1% of patients were treated by anti TNF alpha agents within the last year.