Cervical spondylotic myelopathy (CSM) is a commonly encountered surgical disease that may occur for a variety of reasons. Laminoplasty and laminectomy with or without fusion are two common posterior procedures for the treatment of multilevel CSM. Laminoplasty is a technique that indirectly decompresses the spinal cord and preserves neck motion by hinging the laminae open on one or both sides, to allow the spinal cord to migrate posteriorly away from anterior compressive structures. The goal of this chapter is to discuss the advantages and disadvantages of laminoplasty and laminectomy by referring to the key technical points regarding different surgical techniques of these procedures.