Objective To explore the effect of Mycobacterium tuberculosis infection on the primary cilia of monocytse-macrophages and its potential mechanisms of promoting osteoclast differentiation. Methods Bone marrow-derived mononuclear cells (BMMCs) isolated from patients in control group and spinal tuberculosis group (TB group) were performed in vitro culture, and then cultured with Mycobacterium tuberculosis, infection model (Rv group) was constructed. Changes in cilia were observed by fluorescence staining and scanning electron microscopy technique, a mouse spinal TB model was constructed for validating. Results Compared with the control group, the expression of primary cili markers in the lesion of bone tissue of patients in TB group decreased significantly; After co-culturing with Mycobacterium tuberculosis, the ratio (48.56%±7.77% vs 9.58%±5.59%) and length (4.050［3.289, 4.666］ μm vs 0［0, 0.676］ μm) of primary cilia of monocytes-macrophages in the Rv group decreased significantly; The infiltration of osteoclasts in the bone marrow cavity of spinal TB mice was obvious, and the proportion and length of primary cilia decreased significantly. Conclusion Intracellular infection of Mycobacterium tuberculosis can induce degradation of primary cilia in monocytes-macrophages, promote osteoclast differentiation, and exacerbate vertebral bone resorption.