Background: The concept of enhanced recovery after surgery (ERAS) spread to different surgical specialties to minimize surgical stress response, improve patient outcomes, and reduce the length of hospital stay (LOS). This study aimed to describe the early experience with an evidence-based ERAS pathway for anterior cervical discectomy and fusion (ACDF). Methods: This is a cohort study of retrospectively collected data. The ERAS pathway was created based on available evidence for anterior cervical spine surgery. Patients were followed up to postoperative day 30. Patient data were collected from a database, including demographics, pain score, postoperative complications, and LOS. Compliance with pathway elements was also noted. Results: Thirty-two patients were cared for under the pathway (n = 32). The median LOS was 44 hours, 26 minutes [interquartile range (IQR) 41–46 hours]. Reasons for extended stay longer than 48 hours in six patients included pain (n = 2), dyspnea (n = 1), and dysphagia (n = 3). The median LOS for the six patients who required extended stay was 73 hours [IQR 64 hours 30 minutes–81 hours]. Overall pathway compliance was 83.49%. The median number of ERAS process elements delivered to each patient was 15. There were no complications requiring readmission. Conclusion: The ERAS pathway for ACDF represents an opportunity for safe, prompt discharge. The ERAS pathway can be associated with minimal complications and no readmissions within 30 days of surgery. Further comparative studies are required to confirm the potential benefits of ERAS and the reduction in LOS. Key message: Implementing ERAS protocols helps improve patient experience and outcomes, and reduces cost and LOS.