Cervical spine complaints are routinely evaluated in the office and urgent care facilities. Many of these complaints will resolve with conservative modalities. However, when operative intervention is necessary for nontraumatic pathology, recognition of pre-, intra-, and postoperative complications is imperative. This article reviews basic anatomy and surgical anatomy of the cervical spine. The common surgical approaches to the cervical spine as well complications that can occur from an anterior and posterior perspective are discussed. Cervical spine surgery when used in the appropriate clinical scenarios can be very successful. It is important to remember that risk reduction begins prior to the surgery with appropriate planning, identification of any anatomical anomalies, and adequate preparation.