We treated a 41-year-old man who presented with dysphagia, fever and respiratory distress. Magnetic resonance imaging (MRI) showed a large retropharyngeal abscess (RPA) extending to the C5-6 level, C5-6 spondylodiscitis and a spinal epidural abscess. The RPA was drained surgically under emergency conditions. Because the tuberculin skin test was positive, the patient underwent a triple anti-tuberculous drugs regimen. After six months of drug therapy, the epidural abscess was completely resolved. One of the most important aetiologies of RPA is thought to be tuberculous spondylodiscitis, and cervical vertebrae should be scanned thoroughly with pre-operative MRI.