Cervical arthroplasty has undergone a rapid evolution since the development of the original Cummins device. The evolution of metal-on-metal implants has occurred in parallel with the development of novel bearing concepts incorporating metal alloys, polymers, and ceramics. The current “state of the data” is presented including clinical outcomes of recently developed devices. While the early data from clinical trials are encouraging, there remains a need to demonstrate the viability of such techniques in the long term.