Tetanus is a life-threatening and fatal disease that can be prevented by vaccination. The diagnosis of tetanus is based solely on medical history and clinical symptoms and is very prone to misdiagnosis, undertreatment, and delayed treatment. We reported a deaf and mute patient with tetanus with low back pain, bilateral knee pain, and abdominal distension and constipation as the first symptoms. The patient visited the department of orthopedic pain management with low back pain, bilateral knee pain and abdominal distension and constipation as the chief complaint. During treatment, he was found to have symptoms such as fatigue, coughing with yellow sputum, neck stiffness and discomfort, bilateral temporomandibular joint pain and difficulty in opening the mouth gradually developed after a history of contaminated wound trauma, and thoracic muscle spasm, abdominal muscle tension and neck muscle spasm detected by physical examination, then he was diagnosed with tetanus and transferred to the neuro-ICU department for antitoxin treatment of tetanus and other symptomatic treatments, and discharged after 22-day treatment. Our case report and literature review suggest that to properly prevent and treat tetanus to reduce the risk of tetanus mortality, clinicians should strengthen the propaganda of preventing tetanus by preventive vaccination and timely vaccination after a contaminated traumatic wound, and pay attention to improve their capabilities of identifying, diagnosing and managing tetanus to reduce the possibility of misdiagnosis, and to timely deliver effective treatment after making a correct diagnosis.