Cervical spondylotic myelopathy (CSM) is a disorder with an increasing prevalence. CSM is an impaired function of the spinal cord caused by degenerative changes in the cervical spine that results in compression of the spinal cord. Symptoms of CSM are the instability of gait, loss of fine motor control of the upper limbs, numbness in the hands, weakness of the hands and legs, neck pain and stiffness, and urinary emergency. The vague nature of early myelopathic symptoms is often responsible for the diagnostic delay. The diagnosis of CSM is based on the patient’s history and clinical examination. Additional diagnostic studies, such as radiographs, magnetic resonance imaging, computed tomography, bone scan, electromyography, somatosensory evoked potentials, and motor evoked potentials, can help to provide further information useful for the management of the patient. The differential diagnosis includes any condition associated with neck pain, arm pain, motor-sensory-reflex changes, and signs of spinal cord dysfunction.