This study involved 107 patients selected according to symptoms and signs of myelopathy due to cervical spondylosis. All patients were examined by high resolution CT without intravenous or intrathecal contrast enhancement. Diagnostic accuracy of CT is discussed with regard to idiopathic and degenerative cervical spinal stenosis. Emphasis is placed on CT findings of ossification of posterior longitudinal ligament. The authors conclude that plain CT may be a reliable method for diagnosing cervical spondylothic myelopathy. Nevertheless the authors stress how intrathecal contrast enhanced CT is far superior to plain CT in the selection of a definitive anterior or lateral surgical approach without a delay.