The syndrome of acute central cervical spinal-cord damage, as originally described by Bailey and subsequently by Schneider, Cherry, and Pantek, consists of disproportionately greater weakness in the upper extremities as compared with the lower, with various sensory changes at or below the site of the lesion, and urinary bladder dysfunction. Three patients with this problem are presented. The mechanism of injury is discussed and related to pre-existing conditions such as cervical spondylosis as well as acute pathological entities causing central cord damage, such as hematomyelia, contusion, cord swelling, and ischemia. The treatment and prognosis of patients with this type of spinal-cord injury is outlined.