With the recent release and upcoming release of several cervical disc replacements, we are potentially at the juncture of a major change in practice habits. The present article reviews the most recent research into the rationale, patient selection, clinical results and complication profile of cervical arthroplasty. Recent results of prospective randomized controlled trials comparing cervical disc replacement and anterior fusion have demonstrated safety as well as equal or superior clinical results. In vivo kinematic studies also suggest decreased rates of adjacent segment disease after disc replacement. Increasingly, more studies are examining the complication profile and emerging contraindications for cervical disc replacement. Cervical arthroplasty is a new technique in its infancy of development. Understanding potential complications and pitfalls will ensure correct patient selection and avoidance of common preventable complications associated with cervical arthroplasty. Although initial results appear promising, long-term data are eagerly awaited before a final decision on the value of this procedure can be made.