The objective of this study was to prospectively evaluate the accuracy of MR myelography for the demonstration of foraminal nerve root impingement in cervical spondylotic radiculopathy. 40 patients with cervical spondylotic radiculopathy were imaged with conventional MRI and with MR myelography. The diagnostic accuracy of these imaging strategies for the demonstration of exit foraminal stenosis was calculated relative to a gold standard of the combination of conventional MRI and MR myelography. Conventional MRI had a sensitivity of 88.9%, specificity of 99.1%, and diagnostic accuracy of 94.5% for the demonstration of exit foraminal disease (p<0.001). MR myelography alone had a sensitivity of 84.4%, a specificity of 90.1%, and diagnostic accuracy of 88% (p<0.001). However, the addition of MR myelography increased the diagnostic yield of the MR examination for the detection of foraminal stenotic disease. MR myelography is a useful adjunct to conventional MRI in the investigation of cervical spondylotic radiculopathy.