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STUDY DESIGN Retrospective cohort study. OBJECTIVE To determine the differences in 30-day readmission, reoperation, and morbidity for patients undergoing multilevel anterior cervical discectomy and fusion (ACDF) or single and multilevel anterior cervical corpectomy and fusion (ACCF). SUMMARY OF BACKGROUND DATA Despite increasing rates of surgical treatment of cervical spine disease, few studies have compared outcomes by surgical technique. To the best of our knowledge, this is the only large-scale administrative database study that directly evaluates early-outcomes between multilevel ACDF and single and multilevel ACCF. METHODS Patients who underwent ACDF and ACCF were identified using the NSQIP database. Multivariate regression was utilized to compare rates of readmission, reoperation, morbidity, and specific complications between surgical techniques, and to evaluate for predictors of primary outcomes. RESULTS We identified 15,600 patients. ACCF independently predicted (p < 0.001) greater reoperation (OR = 1.876) and morbidity (OR = 1.700), but not readmission, on multivariate analysis. ACCF was also associated with greater rates of transfusion (OR = 3.273,p < 0.001) and DVT/thrombophlebitis (OR = 2.852, p = 0.001). ACCF had significantly (p < 0.001) greater operative time and length of stay. In the cohort, increasing age (p < 0.001), diabetes (p = 0.025), COPD (p = 0.027), disseminated cancer (p = 0.009), and ASA-class≥3 (p < 0.001) predicted readmission. Age (p = 0.011), female gender (p = 0.001), heart failure (p = 0.002), ASA-class≥3 (p < 0.001), and increased creatinine (p = 0.044), white cell count (p = 0.033), and length of stay (p < 0.001) predicted reoperation. Age (p < 0.001), female gender (p = 0.002), disseminated cancer (p = 0.010), ASA-class≥3 (p < 0.001), increased white cell count (p = 0.036) and length of stay (p < 0.001), and decreased hematocrit (p < 0.001) predicted morbidity. Within ACDF, ≥3 levels treated compared to 2 levels did not predict poorer 30-day outcomes. CONCLUSIONS Compared to multilevel ACDF, ACCF was associated with an 88% increased odds of reoperation and 70% increased odds of morbidity; readmission was similar between techniques. Older age, higher ASA-class, and specific comorbidities predicted poorer 30-day outcomes. These findings can guide surgical solution given specific factors. LEVEL OF EVIDENCE 3.