OBJECTIVE To present the clinical and neurological features of a patient suffering from cervical spondylotic myelopathy. METHODS Cervical spondylotic myelopathy (CSM) is a condition in which the vascular and neural structures are compressed by bony spurring and soft tissue hypertrophy, causing ischemic damage to the spinal cord. Although cervical spondylotic myelopathy is the most common cord disorder in older adults, the diagnosis is often missed because the initial symptoms are subtle and the condition usually presents with associated conditions such as nerve root involvement. METHODS The patient was referred to a neurosurgeon for a posterior decompressive laminectomy. The advancing symptoms of CSM were apparently halted by the surgery in this case, until complication from a fall resulted in quadriplegia. CONCLUSIONS Appropriate testing can aid differential diagnosis of the condition and expedite appropriate management of the condition. Treatment may include surgical cervical decompression of the involved area. An untreated progressive spondylotic myelopathy may cause permanent neurological damage to the spinal cord. Attention should be paid to the clinical signs and treatment of this underdiagnosed condition.