The aim of this study was to assess the incidence and severity of dysphagia following anterior cervical spine surgery for cervical spondylosis. One-hundred patients were contacted 12-22 months following cervical spine surgery. Those reporting persistent swallowing impairment were invited to attend for further investigation. Of 73 respondents, 33 (45%) experienced postoperative dysphagia. This persisted for longer than 6 months in nine (12% of respondents). Of five subjects attending for investigation, none had a definite radiological abnormality. In contrast, manometry suggested hyperactivity of the pharyngo-oesophageal segment in these patients, although with normal co-ordination. Surgeons should warn of the risk of transient dysphagia in 45% of patients postoperatively and of its persistence in around 10%. Radiological examination may be normal and manometry is the investigation of choice. Persistent, severe dysphagia may be ameliorated by cricopharyngeal myotomy or pharyngeal dilatation.