Axial spondyloarthritis (axSpA) is associated with a number of extra-articular manifestations (EAMs) reflecting shared clinical, genetic, and pathophysiological features. The EAMs are considered part of the spondyloarthritis spectrum and should be differentiated from complications arising as a consequence of the disease (covered in a separate chapter). The key EAMs of axSpA are inflammatory bowel disease (IBD), uveitis, and psoriasis. EAMs carry their own morbidity and often warrant treatment in their own right. Furthermore, the presence of EAMs may influence the choice of therapy used to treat the underlying axSpA. Clinicians should ensure that the well-recognized EAMs of axSpA are actively and regularly enquired about when reviewing patients with axSpA.