Cervical spondylotic myelopathy is a degenerative disease that often requires surgical intervention. Postoperative cerebral ischemia is a rare but serious complication of cervical disc herniation surgery, with its pathophysiology poorly described. Intraoperative carotid manipulation is the most likely cause of this ischemia. We report a case of ischemic stroke as a complication following cervical disc herniation surgery in a 52-year-old patient. The patient developed left hemiplegia and central facial palsy immediately after surgery. Imaging revealed an ischemic stroke in the right Sylvian territory associated with atherosclerotic changes in the right common carotid artery. Early postoperative rehabilitation and antiplatelet therapy led to partial recovery. This case highlights the importance of careful carotid management during surgery and the need for preoperative assessment in high-risk patients.