A 58-year-old man with refractory ulcerative colitis underwent subtotal colectomy 4 months after the diagnosis. He developed intense back pain and high fever 9 days after the operation. Findings of a CT scan and an MRI confirmed the diagnosis of pyogenic spondylitis, and Candida albicans was cultured from the biopsy specimen. His clinical condition gradually improved after receiving therapy with rest and antifungal agents. Physicians should be aware of the possibility of pyogenic spondylitis in patients with back pain is treated for ulcerative colitis.