Cervical kyphotic deformity represents a difficult to treat pathology often arising from multiple factors including, but not limited to, traumatic injuries, degenerative changes, and ankylosing spondylitis. Furthermore, treatment of these deformities becomes increasingly difficult with any preexisting instrumentation. Currently, several options exist to treat these severe deformities, with the Smith-Petersen osteotomy and C-7 pedicle subtraction osteotomy being the most frequently used approaches. However, these techniques come with significant risk to the patient including nerve root injury as well as compression of the vertebral arteries. The authors here report on a series of 4 patients with rigid cervical deformity who underwent T-1 pedicle subtraction osteotomy. The authors review the relevant literature and provide a novel, less risky, and potentially more corrective approach for treating cervical deformities.