Abstract: Objective To discuss the cause and treatment of transient paralysis after anterior cervical discectomy and fusion (ACDF). Methods Clinical data about 1 550 cases who underwent ACDF in our hospital from January 2009 to December 2013 were retrospectively analyzed, including 992 males and 558 females with an average age of 43.2 years old (range from 23-84 years old). All patients were followed up for 10 months. Statistical analysis was used to analyze the segmental resection operation, gender, age and cervical spondylosis types. Results Fourteen cases suffered from transient paralysis, including 10 males and 4 females with an average age of 50.6 years old (range from 35-61 years old). Incidence rate of transient paralysis was 0.903%. Male, middleaged patients with multiple segmental cervical spine surgery had higher incidence of postoperative transient paralysis. Conclusion Postoperative transient paralysis is a rare and serious complication after ACDF. Hematoma oppression, spinal cord edema, ischemiareperfusion injury may be possible causes. Good prognosis can be obtained by early diagnosis and intervention.