The complication and mortality rates of anterior cervical fusion surgery in patients 80 years of age and older were assessed in this study. A comparison of these rates against those of other elderly patients was also performed. In this specified age group, chances of developing a major medical complication or mortality were greater than those who were operated at 65 to 79 years of age. For patients 80 years of age or older, the documented rates for dysphagia, aspiration pneumonitis, and reintubation were markedly higher. Although complication rates may be higher in this patient population, carefully selected patients could potentially derive much benefit from surgery and should not be screened out solely on the basis of age.