Considerable controversy exists in the orthopedic and neurosurgical literature over the true incidence and nature of spinal deformity after multiple-level cervical laminectomy in children. Eighty-nine patients with a mean radiographic follow up of 5.1 years (range 2–9 years) were reviewed. Mean age at surgery was 5.7 years (range 1 month-18 years). Most common diagnoses were Arnold-Chiari malformation, syringomyelia, or both (81%). Significant deformity developed in 46 patients (53%), with 33 developing a mean kyphosis of 300 (range 5–1050) and 13 developing a mean hyperlordosis of 62% (range 5–1050) and 13 developing a mean hyperlodosis of 62% (range 40–950), Peak age at surgery of 10.5 years correlated weakly (P = 0.08) with the development of kyphosis. The development of hyperlordosis was strongly correlated (P = 0.01) with a peak age at surgery of 4.2 years. There was no correlation between diagnosis, sex, location, or number of levels decompressed and the subsequent development of deformity.