The three main basic concepts in the understanding and management of tetanus: (1) Tetanus is polysystemic in terms of pathology and management. Most body organs, as well as the nervous system, are severely affected by tetanus toxins (2) Prevention is not only by immunization, but also by specific treatment. Since the toxin cannot be therapeutically eradicated from the body, therapy is directed towards preventing continued spread of the toxins and the consequences of intoxication (3) Variability in terms of prevalence and prognosis. The natural incidence and severity of tetanus varies greatly with social environment, season, climate and soil. Prognosis is influenced by age, source of infection and delay in treatment.