&NA;The outcome of microscopic anterior cervical discectomy with iliac crest interbody fusion in a group of 75 patients was compared with that of microscopic anterior cervical discectomy with synthetic hydroxylapatite fusion in a group of 84 patients. The rate of relief of myelopathy (70%) was similar in both groups, but those who underwent synthetic fusion had better long‐term relief of radiculopathy, less need for a second operation at the same or an adjacent level, no resorption of the bone plug, comparable spinal alignment and stability, and the elimination of complications at the iliac crest donor site. The data suggest that hydroxylapatite fusion may be equal or superior to autologous iliac crest interbody fusion for anterior cervical disc surgery. (Neurosurgery25:39‐43, 1989)