Objective To investigate the effect of anterior cervical ACDF surgery on sagittal cervical alignment。Methods From May 2019 to March 2020, 116 patients with degenerative cervical spondylosis who underwent anterior cervical ACDF surgery in our hospital were retrospectively analyzed. The sagittal parameters of cervical spine, JOA score, NDI score and VAS score were measured before and after operation Results All patients were followed up for an average of 12 months, and the c2-7sva value decreased after operation, with no significant difference (P > 0.05); the c2-7cobb angle increased after operation, the intervertebral space height increased, and the JOA score and NDI score at the last follow-up were significantly higher than those before operation, and the VAS pain score decreased, with significant difference (P < 0.05). Conclusion ACDF can not only relieve the compression of spinal cord and nerve, relieve the pain of neck and shoulder, improve the nerve function and quality of life, but also improve the sagittal morphology of cervical spine, restore the height of intervertebral space and physiological curvature of cervical spine, and obtain good balance of cervical spine.