Abstract Objective Although previous reports suggest that surgery can improve the pain and disability of cervical spinal deformity (CSD), techniques are not standardized. Our objective was to assess for consensus on recommended surgical plans for CSD treatment. Methods 18 CSD cases were assembled, including a clinical vignette, cervical imaging (x-rays, CT/MRI), and full-length standing x-rays. Fourteen deformity surgeons (10 orthopedic, 4 neurosurgery) were queried regarding recommended surgical plan. Results There was marked variation in treatment plans across all deformity types. Even for the least complex deformities (moderate mid-cervical apex kyphosis), there was lack of agreement on approach (50% combined anterior-posterior, 25%, anterior-only, 25% posterior-only), number of anterior (range: 2-6) and posterior (range: 4-16) fusion levels, and types of osteotomies. As the kyphosis apex moved caudally (cervical-thoracic junction/upper thoracic spine) and for cases with chin-on-chest kyphosis, >80% of surgeons agreed on a posterior-only approach and >70% recommended a pedicle subtraction osteotomy (PSO) or vertebral column resection (VCR), but the range in number of anterior (4-8) and posterior (4-27) fusion levels was exceptionally broad. Cases of cervical/cervical-thoracic scoliosis had the least agreement for approach (48% posterior-only, 33% combined anterior-posterior, 17% anterior-posterior-anterior or posterior-anterior-posterior, 2% anterior-only) and had broad variation in number of anterior (2-5) and posterior (6-19) fusion levels, and recommended osteotomies (41% PSO/VCR). Conclusions Among a panel of deformity surgeons, there was marked lack of consensus on recommended surgical approach, osteotomies and fusion levels for CSD. Further study is warranted to assess whether specific surgical treatment approaches are associated with better outcomes.