<p>The aim of this study was to investigate the incidence of symptoms in patients after anterior cervical spine surgery, to construct a symptom network, identify core symptoms and symptom clusters, and provide a theoretical basis for specified symptom management. A total of 375 patients who underwent anterior cervical spine surgery in a tertiary hospital in Zhejiang Province from January to August 2025 were selected using the convenience sampling method, a self-designed general information questionnaire and the MD Anderson Symptom Inventory–Head and Neck Cancer Module were used to evaluate the occurrence of patients’ symptoms. Exploratory factor analysis was conducted to extract the symptom clusters of patients after anterior cervical spine surgery. The symptom network was constructed in R language and the central indicators were analyzed. The four most common symptoms after anterior cervical spine surgery were difficulty swallowing/chewing (95.5%), sore mouth/throat (91.8%), dry mouth (91.5%), and constipation (89.1%). The four symptom clusters extracted were the pharyngolaryngeal and dysphagia symptom cluster, gastrointestinal symptom cluster, neurosensory symptom cluster, and somatic-cognitive symptom cluster, with a cumulative variance contribution rate of 66.38%. In the symptom cluster network, sore mouth/throat (rs = 2.08), difficulty swallowing/chewing (rs = 1.29), fatigue (rs = 1.19), and dry mouth (rs = 0.97) were the strongest symptoms among the four symptom groups. Sore mouth/throat, difficulty swallowing/chewing, fatigue, and dry mouth are the core symptoms of patients after anterior cervical spine surgery, and the pharyngolaryngeal and dysphagia symptom cluster is the core symptom cluster. It is recommended that medical staff formulate interventions according to the core symptoms and symptom clusters of patients. In addition, precise symptom management should be implemented.</p>