Objective To investigate perioperative clinical features and results of surgical treatment of cervical spondylotic myelopathy (CSM) in aged patients (≥ 70 years). Methods From January 1993 to October 1998, 43 patients with CSM undergone surgery were reviewed. The average age at the time of surgery was 72.3 years (ranged from 70 to 84 years). Twenty six patients had associated conditions, i.e. diabetes mellitus in 4, coronary heart disease in 6, hypertension in 12, arrhythmia in 12, cerebral vascular disease in 4. Laminoplasty in 38 patients and anterior decompression in 5 patients were performed. Results After operation there were arrhythmia in 2 patients, stress ulcer in 1, acidosis ketosis in one case of diabetes mellitus, epidural hematoma in 2, delayed healing in 1, leakage of cerebrospinal fluid in 2. The preoperative JOA score ranged from 2 to 13 points, with an average of 6.7. Twenty nine patients were followed up for 6－ 60 months, with a mean period of 24.6 months, JOA score ranged from 7 to 17 points, and in average the recovery rate was 65.2％ ;11 of 29 were excellent, 11 good, 6 fair, 1 poor. Conclusion If the associated disorders and complications in aged patients with CSM are properly handled, the perioperative period will be safe. Surgical decompression for CSM appears to be a beneficial procedure even for the aged patients.