Since they were introduced in 1950, ventral approaches for surgical operations on the cervical spine have become widely used. The most frequently used is the anteromedian approach, passing along the anterior border of the sternocleidomastoideus muscle and then between the upper gastrointestinal tract and the vascular bundle to give access to the spine. This approach allows access to practically every segment of the cervical spine. The significance of the transoral approach is stressed in the literature, and we ourselves are also convinced of its importance. In this paper, however, the combined anteroposterior procedures and the cervicothoracic methods used for the transitional zone are also described. Complications affecting the upper gastrointestinal tract, the vessels or the nerves are always possible, and to reduce their likelihood to a minimum it is essential to make a detailed study of the complicated anatomy of the neck region.