To evaluate the incidence and prevalence of ankylosing spondylitis (AS) in southern Albania and to assess the association of various demographic risk factors with the severity of disease. This is an observational study with cross-sectional analyses, conducted in the region of Gjirokaster, between 1995 until 2011. The diagnosis of AS was based on the modified New York criteria. Data on population are obtained from the reports of the National Institute of Statistics. Between 1995 and 2011, there were 54 patients diagnosed with AS. Of them, 48 subjects were males (88.9%) and 6 subjects females (11.1%). The AS prevalence in adult population (≥14 years of age), in December 2010, was 0.061%. The 5-year incidence (2006-2010) in adult population was 0.006 %. The mean age at the onset of disease was 29.7±8.4 years. The mean age in 2011 (n=50 subjects) was 51.6±12.7 years. The duration of the disease was 22.7±11.2 years. More than two thirds of the patients (70.3%) were in the advanced radiological stages of the disease. A younger age at the onset of the disease, longer delay in diagnosis, lower educational level and smoking were significant independent factors associated with the advanced forms of the disease. In southern Albania, the AS prevalence in 2010 was 0.061% and the 5-year incidence (2006-2010) was 6 new cases per 105 adults. The incidence and prevalence of AS in Southern Albania are close to the respective regional epidemiological data.