Background: Thoracolumbar junction spine i.e. T11-L1 is a transition zone between the more stable T1-T10 spine which is connected by rib cage to the sternum & the more mobile L2-L5 spine. There are several factors that affect the outcome; but which are these factors are determining the outcomes are still unknown. Objective: To study and evaluate the factors influencing the outcome following acute thoraco lumbar junction spine injury. Materials and Methods: A prospective observational study at Department of Forensic Medicine, Kushtia Medical College, Kushtia, Bangladesh with all patients with thoracolumbar junction (TLJ) spine injury, attending our hospital within a week of injury during a period of November 2017 to August 2019 were included for analysis. Demographic factors like age, gender, aetiology of injury, pre op ASIA grade, thoraco lumbar injury classification and severity score (TLICS), imageological factors on MRI and timing of intervention were studied. Change in neurological status by one or more ASIA grade from the date of admission to 6months follow up was taken as improvement. Functional grading was assessed using functional independence measure (FIM) scale at 6months follow up. Results: A total of 25 patients with acute thoracolumbar junction (TLJ) spine injury, managed surgically were included in this study. Follow up was available for all patients at 6months. No improvement was noted in patients with ASIA grade A. Maximum improvement was noted in ASIA D group (83.3%).Patient with cord contusion showed mild improvement as opposed to those with just oedema wherein the improvement was seen in 75% patients. Maximum improvement in FIM score was noted in ASIA grade D and patients who had oedema in MRI TLJ spine. Conclusions: Incomplete spinal cord injury, patients showing MRI oedema have good improvement in neurological status at 6months follow up.