Foraminal stenosis is an important cause of cervical radiculopathy, which can be treated with an anterior or posterior approach, depending on a number of factors. These include the etiology of the foraminal stenosis, individual patient risk factors, and surgeon preference. We provide a step-by-step technique guide for performing an open posterior cervical foraminotomy on a 33-yr-old male with a history of left-sided pain radiating down the medial aspect of his left arm and left triceps weakness. Magnetic resonance imaging demonstrated a left-sided C6-7 disc herniation causing foraminal stenosis. Guidance on positioning, relevant anatomy, and appropriately planning the extent of bony decompression is also provided in this video. The patient, who consented to the recording of this surgical video, tolerated the procedure without complication, and upon follow-up had a significant improvement in his symptoms. Copyright © 2019 by the Congress of Neurological Surgeons.