BACKGROUND In this article, we describe 14 case reports of using ultrasound guidance to facilitate blockade of the cervical nerve root. METHODS A total of 14 ultrasound-guided selective cervical nerve root blocks using fluoroscopy were performed in 10 patients. The target point was the spinal nerve root between the anterior and posterior tubercles of the most lateral aspect of the transverse process C3-7, and C8 nerve root on the first rib. The key landmark was the C7 vertebra because of the absence of the anterior tubercle. RESULTS All of the ultrasound-guided needles were placed accurately. There were no intravascular injections under real-time fluoroscopy. There were no complications. CONCLUSIONS We conclude that ultrasound guidance might be useful for cervical nerve root blocks by improving nerve and vascular localization, and injections under real-time fluoroscopy might make this block safer by identification of the intravascular injection.