There are race-related differences in the prevalence of AS/SpA. Asian and Pacific regions contain many countries and regions, and many different races and nations. The purpose of this article is to summarize the epidemiology data from these contries, to describe the clinical features of Asian AS/SpA patients, and to compare the clinic and genetic difference between different races. The prevalence of AS/SpA in Chinese and Thai are similar to that in Caucasian, while that of Japanese is much lower because of low prevalence of HLA-B27. The sporadic USpA has different genetic predisposition compared with familial USpA. Patients with Juvenile onset ankylosing spondylitis (JAS) have fewer and milder spinal symptoms and more peripheral joint involvement than those with adult onset ankylosing spondylitis (AAS). The Middle East Arab patients have more tendency to present with AS and have family history, compared to South Asian patients. The native Indonesian AS patients tend to have HLA-B2705 subtype while most of Indonesian Chinese patients have B2704 subtype. Different designed questionnaires are used in the above prevalence surveys. We suggest that validation and evaluation of these questionnaires should be carried out in the future epidemiology study.