SummaryAnterior cervical plates are widely accepted as a form of internal fixation for discectomy and corpectomy reconstructions in the setting of trauma, deformity, degenerative disc disease, and tumor surgery in the cervical spine. The techniques for anterior cervical surgery with application of internal fixation have become a standard part of the spine surgeon’s armamentarium, but the types of plates available and the rationale behind their designs are quite varied. In the past 20 years, the complication rates associated with anterior cervical surgery have decreased, as compared with historical controls, but a 100% fusion rate remains elusive. Recent developments in cervical plate technology include the introduction of variable angle locking screws that mate securely with a cervical plate, monocortical screws that decrease the neurologic risks associated with penetration of the far cortex in the cervical spine, and dynamic cervical plates that are designed to permit a greater degree of load sharing between the interbody graft and the plate. In light of these advances, we review the history of anterior cervical plating, the surgical techniques, the design characteristics of several plates in common use, and the clinical results of surgical procedures performed with and without internal fixation.