ACDF is a surgical procedure performed when herniated disks produce severe pain, or arm/hand weakness. Severe complications occur in ~9% of cases, mainly due to tissue resection adjoining the spinal canal. MRI imaging, performed at several procedure stages, can visualize the extent of resection, and the degree of nerve decompression. We performed ACDF surgery on the MRI table, using an MRI-compatible tool-set. Imaging at 3T was performed at four procedure phases. Imaging disclosed significant spine decompression immediately after disk resection, with smaller changes after osteophyte and posterior longitudinal ligament removal. MRI-monitored ACDF can revise procedure phases, leading to improved outcomes.