Twenty-four patients with acute central cervical cord injury with motor and sensory impairment involving only the upper extremities are described; none had any abnormality in the lower extremities. They were all treated conservatively with one exception in whom an anterior decompression was performed. Seventeen had complete recovery of motor function; the remaining 7 had some weakness of the palmar interosseous muscles. The time to recovery was from 2 weeks to 4 months. Sensory recovery took from 4 to 6 months after injury. This type of injury is caused by damage to the anterior and posterior horn cells in the cervical cord.