This is a retrospective study of twenty-two patients with cervical spondylotic myelopathy who were admitted to the hospital for surgical treatment of their neurological condition. The purpose of the study was to evaluate the presenting symptoms, factors affecting the diagnosis and the course of the disease prior to surgical intervention. The earliest consistent symptom in all of our patients was a gait abnormality. The course of the disease was one of progressive deterioration. Spontaneous regression did not occur in any of the cases. The vagueness of the initial complaints led to considerable delay in the diagnosis (average of 6.3 years). Magnetic Resonance Imaging (MRI) was the most useful test in confirming the diagnosis.