Management of thoracolumbar vertebral fractures is a common consult question encountered by spine surgeons in the emergency setting. When a fracture appears likely to be stable, it is often assessed for stability with an upright thoracolumbar radiograph either with or without a TLSO brace. However, it is unclear how often these upright radiographs change clinical management. Here we present a retrospective study assessing the clinical utility of upright spine radiographs in the setting of acute thoracolumbar vertebral fractures. Our null hypothesis is that these radiographs rarely change management in this subset of fractures.