Computed tomography (CT)–guided selective cervical nerve root blocks, particularly in the dorsal/posterior access, are sensitive, specific, efficacious, and safe. If performed with a lateral/anterolateral access, the CT-fluoroscopic technique with real-time visualization should be chosen. In comparison to fluoroscopy-guided nerve root blocks, CT guidance offers a more precise visualization of the contrast agent. While the advantages of CT guidance seem to outweigh the slightly higher exposure to radiation, this specific topic is debatable and requires additional scientific inquiry. Comparative studies are needed to address the sensitivity, specificity, efficacy, complication rates, and radiation exposure of CT- and fluoroscopy-guided cervical nerve root blocks.