Through the myriad of abnormalities encountered by spine surgeons, neck pain is one of the most perplexing. The nature, onset, and location of the pain all provide information as to what the potential pain generator may be. By synthesizing data garnered from the physical examination, imaging studies, and history, a spine surgeon must formulate a differential diagnosis and treatment plan. The surgeon must determine whether the patient has cervical radiculopathy, myelopathy, or simply cervical spondylosis because the treatment of each of these is vastly different.