Abstract: Ossification of the posterior longitudinal ligament of cervical spine(OPLL) refers to a group of neurological impairment syndromes caused by ossification of the posterior longitudinal ligament of cervical vertebra, which compresses the spinal cord and nerve root, and is one of the important causes of cervical spondylosis. Ossification of the posterior longitudinal ligament is a rare pathological process of lamellar bone deposition that can lead to spinal cord compression. Although studies have found that the occurrence and development of OPLL are related to a variety of genetic and environmental factors, the understanding of its pathophysiology is still unclear. Asymptomatic patients can be treated conservatively, nerve root or surgical decompression should be considered in patients with spinal cord disease can be carried out on the nerve, spinal cord decompression surgery, slow progress in OPLL, but is also likely to be dural tear, nerve damage and axial pain related complications, such as the choice of treatment has been a problem in the physician, the influence of different treatments on prognosis, different shape and size, and location of OPLL is important to the choice of surgical approach and technique, and nerve function, image credits can also guide the choice of treatment. The epidemiology, pathological anatomy and pathophysiology, clinical manifestations and imaging manifestations of cervical OPLL treatment still need to be further studied. In this review, our goal is to address the existing literature on the etiology, history, presentation, and management of OPLL, to make generalizations to better understand OPLL, and to provide our recommendations for the treatment of OPLL patients.