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Ischemic infarction of the spinal cord usually involves the territory of the anterior spinal artery. The most common clinical abnormalities are bilateral limb weakness and impaired pain and temperature sensation with voiding difficulty. We report a case of cervical spinal cord infarction that was noted to have unilateral limb weakness as the initial manifestation without any other symptoms. The diagnosis of cervical spinal cord infarction should be considered in patients with sudden unilateral weakness, regardless of the extent of sensory or voiding impairment.