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Cervical epidural steroid injections (ESIs) are standard interventions for treating cervical radicular pain, yet both transforaminal and interlaminar approaches carry rare but catastrophic risks including spinal cord injury.1 2 Additional complexity arises in patient populations, such as those taking anticoagulants, are pregnant, or have high cervical radicular pathology, in whom the risk of interlaminar ESIs must be carefully considered.3 Cervical retrolaminar blocks (RLBs) have emerged as a novel extra-neuraxial alternative to treat cervical radicular pain.4 5 This letter critically examines the evidence for cervical RLBs, emphasizing that while the anatomical rationale and early data are compelling, controlled or comparative-effectiveness trials are needed before broader adoption.