INTRODUCTION: The dysphagia due to the osteophyte of the anterior cervical spine was reported to occur in the old age and lower cervical spine. The authors experienced a case of dysphagia associated with osteophyte of the 3-4th anterior cervical spine without trauma history in a young man. MATERIALS AND METHODS: A 37-year-old man presented with the dysphagia during 2 months. The lateral radiograph and com-puted tomograph of cervical spine showed 1.5 cm sized anterior osteophyte in the 3-4th cervical vertebrae that compressed the arytenoid cartilage anteriorly. In the finding of video laryngoscopy and endoscopy, the posterior hypopharyngeal wall was pro-truded and reflex gastritis was also seen. Through the anterior approach, the excision of osteophyte, discectomy and bone graft was done. RESULT: Dyaphagia was relieved immediately after the removal of osteophyte. The follow up video laryngoscopy showed that the posterior hypopharyngeal wall was normalized. The radiograph showed bone union and no recurrence at 3 year follow up. CONCLUSION: The surgical removal of anterior cervical osteophyte causing dysphasia showed symptom relief and excellent result at the long-term follow up.