This article reviews the outcome of 23 consecutive patients who developed pseudarthrosis after anterior cervical fusion surgery. Sixteen of the 23 patients failed to achieve significant relief of their symptoms (69.6%). These 16 had a second fusion procedure. Thirteen of this same 16 obtained a fusion, and 9 of these (69.2%) converted to an excellent or good result. These findings support the thesis that solid arthrodesis is important to a successful outcome of anterior cervical fusion procedures.