The purpose of this study was to compare the outcomes of anterior discectomy and fusion (ACDF) versus dynamic cervical implant replacement (DCI) for treating single-level cervical degenerative disc disease (CDDD). Patienta and methods This prospective study included 34 patients with a single-level symptomatic CDDD between C3 and C7, treated with either ACDF or DCI, at two different centres, between 2014 and 2017. The mean age was 38.8±8 (28–57) years. All patients had axial neck and radiculopathy. Cases with myelopathy were excluded. Four patients were lost from follow-up. The remaining 30 cases ( 16 ACDF and 14 DCI ) were followed-up for a mean period of 17.3 ± 7.2 ( 12 – 24) months. Results There was no statistical difference in operative time, and intraoperative blood loss, between the two groups. Clinically, the neurologic condition, VAS-scores for neck and arm pains, and neck disability index showed significant, persistant and comparable improvements in both groups. Radiologically; the intervertebral height at treated level and the alignment of C2-7 and of implanted segment showed significant and comparable improvements in both groups. DCI resulted in better ROM of C2-7 and of implanted level than ACDF did. ROM in adjacent segments did not change significantly in both groups. The complications were; transient horseness (n=1), transient dysphagia (n=1), asymptomatic nonprogressive DCI anterior migration (n=1), asymptomatic pseudarthrosis after ACDF (n=2), and symptomatic ASD after ACDF (n=1). Conclusions Both ACDF and DCI arthroplasty are effective and safe; with comparable outcomes, for treatment of single-level CDDD. A longer follow-up period will be needed to determine the long-term effects.