Retrospective case series. To evaluate the use of titanium mesh cages in the reconstruction of the cervical spine following corpectomy. Previous studies have shown high successful fusion rates and low failure rates with this technique. Similar reconstruction techniques using anterior strut bone grafting and anterior plating have shown higher failure rates following multilevel corpectomies. A retrospective review was performed of 23 consecutive patients who underwent anterior cervical corpectomy reconstructed with a titanium mesh cage, local autograft, and fixed anterior plating. Medical records and radiographs were reviewed. Average follow-up was 28 months. Seven patients (30%) had reconstruction failures. There was 1 failure (6%) in the 1-level corpectomy group and 6 (75%) in the multilevel corpectomy group. All failures occurred before 12 weeks after surgery. The remaining patients had successful fusion (70%). There is a high early failure rate (75%) with the use of a titanium mesh cage and fixed anterior plating for reconstruction of multilevel corpectomies. Posterior fusion and instrumentation should be considered when using this technique for multilevel reconstructions.