Background Horner syndrome (HS), defined by the triad of ptosis, miosis, and facial anhidrosis, arises from disruption of the oculosympathetic pathway at any point along its course. The most frequently documented causes include trauma, neoplasms, and iatrogenic injury. Conversely, cervical myelopathy resulting from disc herniation is an uncommon etiology of HS. Case Presentation We describe an unusual presentation of HS in a 64-year-old woman with a large C5–C6 central disc herniation causing severe stenosis and cord compression. Conclusion This case highlights the importance of considering HS as a potential clinical indicator of cervical myelopathy. Prompt recognition and timely referral for surgical decompression are essential, as the recovery is influenced by both the duration and severity of sympathetic fibre compression. Continue Reading