Abstract: Objective To discuss the cause, risk factors and treatment of dysphagia after anterior cervical discectomy and fusion (ACDF). Methods Clinical data about 36 cases with dysphagia selected from 355 cases who accepted ACDF in our hospital from January 2013 to December 2013, including 12 males and 24 females with an average age of 46.6 years old (range from 36-75 years old), were retrospectively analyzed. Results All the 36 patients with dysphagia, whose Bazaz's score were respectively recorded at postoperative 1-4 days, 3rd month and 6th month, were followed up at least 6 months. The incidence rate of dysphagia was 10.1% at postoperative 1-4 days, 6.2% at postoperative 3rd month, and 2.3% at postoperative 6th month. There were no cases with severe dysphagia at postoperative 3rd month. Logistic regression analysis showed that multiple segmental cervical spine surgery and highlevel cervical spine surgery might be the risk factors of postoperative dysphagia. Conclusion Multiple segmental decompression and fusion and high cervical spine surgery are two potential risk factors. The occurrence of dysphagia after ACDF can be avoided by the protection of cervical nerves and the usage of methylprednisolone.