Cervical spondylotic myelopathy (CSM) is a progressive degenerative condition of the cervical spine and the most common cause of spinal cord injury in adults >55 years of age. Degenerative changes in the spine lead to spinal cord compression, resulting in symptoms such as gait instability, loss of dexterity in the hands, weakness, and sensory deficits. Diagnosis is delayed by 2,2–6,3 years and includes clinical examination and imaging such as MRI. Management of CSM is primarily surgical treatment. This review highligths the importance of early recognition and appropriate treatment in optimising patient outcomes.