Abstract: Objective To define the possible risk factors for early complications following anterior surgery for cervical spondy- lotic myelopathy. Methods Two hundred and fifty-eight cases of cervical spondylotic myelopathy receiving anterior surgery between January 1992 and December 2003 were reviewed and the gender, age and other factors of the patients were analyzed with single-factor analysis and multiple logistic regression. Results Complications arising in the early stage after the surgery were found in 19 cases (20 events), with an incidence rate of 7.4%. Single-factor analysis showed that the two factors, paralysis and surgical approaches, were correlated with the early complications, and paralysis was identified as the major factor determining the occurrence of these complications by multiple logistic regression. Conclusion Paralysis is the major factor related to the occurrence of early complications following anterior surgery for cervical spondylotic myelopathy, which reiterates the importance of proper perioperative management.