Abstract:[Objective] To present the surgical techniques and preliminary clinical results of endoscopic anterior cervical discectomy and fusion (E-ACDF). [Methods] E-ACDF was performed on 15 patients with cervical spondylotic myelopathy from January 2021 to February 2023. The intervertebral disc tissue, osteophyte on the vertebral body, and posterior longitudinal ligament protruding into the spinal canal were removed under endoscope, and the anterior dural space was confirmed to be completely decompressed without compression, and the dural beating was restored. As the intervertebral space was extended with a distractor, a fusion cage was implanted into the space, and then anterior cervical plate was placed directly in front of the fusion segment, and was fixed with screws. [Results] All patients were successfully operated without serious complications, and followed up for 6 to 12 months. Compared with those preoperatively, VAS score [(4.7±0.2), (2.2± 0.1), P＜0.001], NDI score [(31.7±1.4), (11.3±0.7), P＜0.001], JOA score [(5.1±0.2), (11.5±0.3), P＜0.001] significantly improved at the latest follow up. Postoperative cervical images revealed internal fixation implants in proper position, with completely decompressed dura and nerve roots. [Conclusion] E-ACDF takes advantage of clear visual surgical field for the treatment of cervical spondylotic myelopathy. It is an accurate, safe and reliable surgical method for full decompression, and achieve satisfactory outcome in short-term.