Ossification of the posterior longitudinal ligament (OPLL), while progressing, compresses the ventral or ventrolateral aspects of the spinal cord causing progressive cervical myelopathy. Dorsal approach is technically less demanding when compared to anterior approach; it is less frequently associated with serious complications such as intraoperative neural injury, symptomatic cerebrospinal fluid leakage, adjacent segment disease, and is more applicable to multisegmental lesions, as it is often the case with OPLL patients. Dorsal procedures include laminectomy alone, laminectomy with fusion, and laminoplasty. Dorsal surgery for OPLL yields satisfactory results in the majority of patients although presence of preoperative cervical kyphosis, severe canal compromise, a history of trauma, or a long duration of symptoms failed to obtain optimal surgical results. For patients with significant preoperative cervical kyphosis and myelopathy, combined anterior posterior surgery should be preferred rather than posterior approach.