Anterior cervical discectomy and fusion (ACDF) has been considered the gold-standard procedure for treating symptomatic cervical spondylosis refractory to conservative management. The aim of this study was to compare the clinical efficacies of anterior cervical discectomy and fusion (ACDF) with Zero-P and ROI-C devices in the treatment of cervical degenerative disc disease (CDDD). Between July 2014 and December 2014, 56 patients underwent ACDF with Zero-P or ROI-C. Pre-, intra-, and postoperative clinical and radiographic outcomes were compared between groups. The visual analogue scale (VAS) pain score, Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, cervical range of motion (CROM) angle, C2-7 Cobb angle, and disc height index (DHI) exhibited significant postoperative improvements in both groups (P< 0.05). The successful treatment rates in both groups were 76%(P> 0.05). In the Zero-P group, the duration for surgeries involving C3-4 or C6-7 was longer than for other surgeries (135.0±19.0 vs. 105.6±17.5 min, P< 0.05). The operative time for surgeries involving C3-4 or C6-7 was significantly shorter for ROI-C than for Zero-P (112.2±20.5 min, P< 0.05). There were no significant differences in the dyspepsia or cage subsidence rates between the Zero-P and ROI-C groups (P> 0.05). The last follow-up Cobb angle in the Zero-P group (24.4±4.5) was significantly higher than that in the ROI-C group (18.1±2.3)(P< 0.05). ACDF with ROI-C showed comparable efficacy with the Zero-P device, with a shorter operation time for surgeries involving C3-4 or C6-7. However, ROI-C may cause more Cobb angle loss over time, which may lead to uncomfortable symptoms. Above all, the surgeon should take individual patient context and personal proficiency into consideration when choosing cage devices.