To explore the value of diffusion kurtosis imaging in the changes of spinal cord microstructures in patients with early cervical spondylotic myelopathy.Twenty nine patients with cervical myelopathy were selected in this study. All images were acquired on a 3.0 T MR scanner (Skyra, Siemens Medical Systems, Germany). The imaging parameters for diffusion kurtosis imaging were as follows: repetition time/echo time, 3000/91 ms; averages, 2; slice thickness/gap, 3/0.3 mm; number of slices, 17; field of view, 230 × 230 mm; Voxel size, 0.4 × 0.4 × 3.0 mm; 3 b-values (0, 1000, and 2000 s/mm) with diffusion encoding in 20 directions for each b-value. Values for fractional anisotropy, mean diffusivity, and mean diffusional kurtosis (MK) were calculated and compared between unaffected and affected spinal cords.In all patients MK was significantly lower in normal appearing spinal cords adjacent to the affected cervical spinal cords than in normal cervical spinal cords (0.862 ± 0.051 vs 0.976 ± 0.0924, P < .0001), but the difference of fractional anisotropy and apparent diffusion coefficient was no significant (P > .05). The affected cervical spinal cords had lower MK (0.716 ± 0.0753), FA and higher apparent diffusion coefficient than normal cervical spinal cords (P < .001).MK values in the cervical spinal cord may reflect microstructural changes of spinal cord damage in cervical myelopathy, and it could potentially provide more information that obtained with conventional diffusion metrics.