Treatment of myelopathy secondary to multilevel cervical spondylosis traditionally has centered on various posterior decompressive procedures or anterior decompression via partial corpectomy and strut grafting. More recently, multilevel anterior cervical discectomy and fusion has been used to treat those suffering from this ailment. In contrast to a posterior approach, an anterior approach has the distinct advantage of directly addressing anterior spinal cord compression. Limiting anterior decompression to the disc spaces may often adequately decompress the spinal cord while saving the patient the added morbidity of multiple partial corpectomies and long-segment strut grafting. This article will attempt to review the pertinent literature regarding this subject and describe the relative indications and contraindications of multilevel anterior cervical discectomy and fusion for the treatment of cervical spondylotic myelopathy.Objectives: Upon completion of this article, the reader should be able to: (1) describe the pathophysiology and natural history of cervical spondylotic myelopathy, and (2) discuss the role of multilevel anterior cervical discectomy and fusion, including indications, contraindications, surgical technique, and potential complications.