Background: Cervical spinal cord injury (SCI) accounts for 2–3% of all trauma patients. Injury to the spine and spinal cord is one of the common cause of disability and death. Several factors affect the outcome; but which are these factors (alone and in combination), are determining the outcomes are still unknown. The aim of the study was to evaluate the factors influencing the outcome following acute cervical spine injury. Materials and Methods: A prospective observational, single‑center, the nonrandomized study of all patients with cervical spinal injury attending Emergency Department within a week of injury, who were surgically managed in the Department of orthopedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh were included in the study. Demographic factors such as age, gender, etiology of injury, preoperative American Spinal Injury Association (ASIA) grade, upper (C2‑C4) versus lower (C5‑C7) cervical level of injury, image logical factors on magnetic resonance imaging (MRI), and timing of intervention were studied. Change in neurological status by one or more ASIA grade from the date of admission to 6 months follow‑up was taken as an improvement. Functional grading was assessed using the functional independence measure (FIM) scale at 6 months follow‑up. Results: A total of 39 patients with an acute cervical spine injury, managed surgically were included in this study. Follow‑up was available for 38 patients at 6 months. No improvement was noted in patients with ASIA Grade A. Maximum improvement was noted in ASIA Grade D group (83.3%). The improvement was more significant in lower cervical region injuries. Patient with cord contusion showed no improvement as opposed to those with just edema wherein; the improvement was seen in 62.5% patients. Percentage of improvement in cord edema ≤3 segments (75%) was significantly higher than edema with >3 segments (42.9%). Maximum improvement in FIM score was noted in ASIA Grade C and patients who had edema