Objective To investigate the effects of anterior cervical decompression and implanting bone fusion with plate internal fixation under microscope on cervical spondylotic myelopathy. Methods 64 patients were performed anterior cervical decompression and implanting bone fusion with plate internal fixation under microscope. They were assessed with the assessment of Japanese Orthopedic Association (JOA), imageologic and clinical finding 6 months after operation. Results The score of JOA improved from (9.1±2.4) pre-operation to (13.5±3.1) post-operation. Imageologic and clinical features showed satisfactory outcome. Conclusion Most patients with cervical spondylotic myelopathy can achieve satisfied prognosis by decompression through anterior approach; microsurgery.