Abstract： Objective To investigate the microneurosurgcial management for intramedullary spinal ependymomas in the superior cervical spinal cord.Methods Clinical data of 23 patients with intramedullary ependymoma in the superior cervical spinal cord were analyzed retrospectively.All the patients were treated by microsurgery assisted with somatosensory evoked potential (SEP) and motor evoked potential (MEP).Results Total removal was achieved in 17 cases,subtotal removal in 5 cases and partial resection in 1 case.No patients died.A follow up of 3 months to 6 years by out - patient review and telephone interview were performed in 22 cases:neurological function was improved in 16 cases(73％ ),no changes occurred in 4( 18％ ),deteriorated in 2 (9％)and none was recurrence.Results of introperative monitoring:18 patients presented true negative findings,while 2 patient presented true positive findings,1 false positive findings.Conclusions Early microsurgical treatment is the most effective measure for intramedullary ependymoma in the superior cervical spinal cord.The combined applications of intraoperative SEP and MEP monitoring can increase removal rate,reduce postoperative complication,and improve the prognosis of the patients.