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Introduction: Various anterior approaches to the cervicothoracic junction have been described. This study reports our experience with 14 patients who had cervical anterior approaches to the cervicothoracic junction (C6-T2). This technique was evaluated with regard to the extent of exposure, ease of technique, and postoperative morbidity. We have chosen the low cervical approach to obtain exposure up to T2. For T3-T4 pathology, we use the transthoracic, periscapular approach. We do not practice bone-splitting approaches because of the morbidity associated with these approaches., Methods: Fourteen patients with C6-T2 pathology who required anterior decompression and fusion were studied for a period of 2 years. In all cases, the low cervical anterior approach was used., Results: This approach is simple, requires less operative time, and provides excellent exposure up to the level of T2. There was no long-term morbidity attributed to the approach and procedure., Conclusion: The low cervical anterior approach is an excellent approach that provides adequate exposure for spinal pathology to T2 that requires anterior decompression and fusion.