Objective: Biopsies of cervical spinal lesions are often challenging procedures with significant risk of complications. Although computed tomography (CT)-guided biopsy of the thoracic and lumbar spine is considered a safe and accurate procedure, cervical spine biopsies are less commonly performed. The aim of this retrospective study was to evaluate the diagnostic accuracy of CT-guided needle biopsies for lesions of the cervical spine. Methods: Results of 27 CT-guided biopsies of cervical spine lesions performed between February 2000 and May 2020 in a tertiary care teaching institute in India were retrieved and analysed. Results: An adequate diagnostic yield was obtained in all 27 cases (100%). There were no major complications. The common pathologies, approaches to the lesions, and the method of biopsy were studied. Conclusion: CT-guided biopsy of the cervical spine with appropriate case selection and planning is a safe procedure with high diagnostic yield.