OBJECTIVE: Cervical stenosis with myelopathy caused by ossification of the ligamentum flavum is relatively rare. Surgical treatment is the preferred option. Previous surgical procedures usually require assisted internal fixation, and some problems may occur, such as large trauma, intraoperative bleeding, wound infection, and internal fixation failure. The aim of this paper is to introduce a new minimally invasive surgical procedure for the treatment of upper cervical spinal stenosis complicated with myelopathy. METHODS: A 56-year-old man with cervical myelopathy (C2-3) caused by calcification of the ligamentum flavum underwent posterior percutaneous full-endoscopic cervical laminectomy and decompression (PECLD) and achieved good clinical efficacy. RESULTS: A surgical incision just 1 cm in size was made, and there was little bleeding during the operation. The patient was hospitalized for 2 days and returned to work after 4 weeks. The patient's postoperative recovery of neurologic function was significantly improved, pain was obviously reduced, and quality of life was remarkably improved. No intra- or postoperative surgical complications were encountered. CONCLUSIONS: PECLD is an effective method for treating cervical stenosis associated with myelopathy because of ossification of the ligamentum flavum. It has the advantages of smaller trauma, less bleeding, shorter postoperative hospital stay, and faster recovery. Taken together, this minimally technique can be considered as a good alternative to traditional open surgery.