Cervical myelopathy consequent on ossification of posterior longitudinal ligament (OPLL) is very rare in Caucasians. A 65-year-old Anglo-Saxon woman developed progressive gait disturbance, paresthesia in both legs and urinary urge incontinence. Radiological examination showed OPLL from fifth to seventh cervical vertebral level; the dense OPLL was graphically displayed by three-dimensional computerized tomography. Medial corpectomy, C5 to C7, and removal of OPLL, with subsequent fusion C4 to Tl using a free fibula graft resulted in clinical improvement. Three dimensional computerized tomographic imaging is a valuable diagnostic procedure in OPLL.