Bush K, et al. - All patients (n = 527) who were undergoing cervical transforaminal epidural steroid injections (CTFESIs) between January 2008 and August 2018 were prospectively enrolled in the study to reflect the significance of operator technique first and foremost and how, with safe and reproducible technique that confidently eludes intra-arterial injection, CTFESI could be performed safely despited the choice of steroid. A total of 1,047 procedures (1,753 individual cervical levels injected) over the study period were done, ie, 1,011 procedures with a particulate steroid (triamcinolone acetonide) and 36 with non-particulate (dexamethasone). Only six complications were found, all instinctively self-resolving without intervention and recognized minor (grade 1). Thus, with fastidious safe technique, CTFESI can be reliable, efficient and cost-effectively administered on an outpatient basis. Moreover, the predominant practice of particulate steroids did not result in any important complications.