Multilevel cervical spondylosis is a common disorder encountered by most actively practicing spine surgeons. Patients can present with a combination of complaints, including mechanical neck pain, radiculopathy, and myelopathy. A comprehensive evaluation is required for appropriate diagnosis and treatment. Accurate interpretation of imaging techniques, including plain x-rays, CT, and MRI, is necessary to formulate the optimal surgical strategy. Key points to address during construction of the operative plan include the direction of approach, the extent of the decompression, and the type of stabilization construct when necessary. This article outlines various techniques to facilitate operative planning, optimize the surgical objective, and minimize potential complications.