The principal focus of the anaesthetist during surgical intervention in a patient with cervical myelopathy is to prevent further deterioration of the neurological system while delivering anaesthetic care. Successful surgical outcome of these patients requires a detailed preoperative review, careful and knowledge based peri-operative anaesthesia care plan and a robust collaboration between the anaesthetic and neuro-surgical teams. We report the case of a 76 year old male medical doctor who presented with progressively worsening symptoms of cervical myelopathy and subsequently had laminectomy and decompression under general anaesthesia relaxant technique. We aim to highlight the place of detailed anaesthetic care plan in the successful management of this patient who was assessed as high risk for both a difficult airway and peri-operative anaesthetic complications associated with anaesthesia for cervical laminectomy and decompression.