Cervical endoscopy is one of the most advanced stages in the learning curve for endoscopic techniques in spine surgery, requiring precise control of instruments to avoid severe complications. We report the case of a 53-year-old female patient with bilateral cervicobrachialgia and myelopathy caused by severe central stenosis at C2-C3. After the failure of conservative treatment, an endoscopic posterior over-the-top cervical decompression was performed. The surgery was completed, with significant improvement in pain and neurological function. At six months of follow-up, the patient showed an increase in her mJOA score, indicating improved functionality. This case demonstrates that the endoscopic technique can be effective and safe in treating cervical stenosis with spinal cord compression and myelopathy. However, further studies are needed to confirm its efficacy compared to other surgical approaches. Level of Evidence IV; Case Report.