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PTS is a distinct clinical syndrome, characterized by acute and severe unilateral shoulder pain followed by paresis with muscle weakness and atrophy of the shoulder girdle. It is notoriously unknown and usually diagnosed with unnecessary delay. In this case based literature review, we report a case of a 59-year-old man with severe left shoulder pain, followed by weakness, after an anterior cervical discectomy and fusion C5C7. Postsurgical PTS is an under-recognized and challenging clinical entity. Early recognition may prevent unnecessary investigations or surgical exploration and it affords to treat the patient properly, leading to greater satisfactions of both surgeon and patient.