Positive leukocyte antigen B27 is generally indicative of the likely presence of spondyloarthropathies, especially ankylosing spondylitis. Human leukocyte antigen B27 is expressed on all nucleated cells in the body, but may be specific in patients with spondyloarthropathies, where this HLA-B27 antigen is hereditary. Human leukocyte antigen B27 positivity is most commonly seen in spondyloarthropathies, especially ankylosing spondylitis, where the positivity rate can be more than 90%. In Wright’s syndrome or reactive arthritis, the positivity rate is 60% to 80%, and in psoriatic arthritis, the positivity rate is 50%. Therefore, individuals who are positive for human leukocyte antigen B27 should be further examined in conjunction with symptoms and imaging to determine the presence of spondyloarthropathies. The presence of ankylosing spondylitis should be highly suspected if there is significant sacroiliac arthropathy, low back pain, stiffness, and limited lumbar spine motion. Therefore, further examination of the sacroiliac joints by CT or MRI is needed to rule out the possibility of ankylosing spondylitis. Specific diagnosis and treatment should be carried out under the guidance of a physician.