Spinal tuberculosis is the most common form of skeletal tuberculosis, and it can be destructive and devastating to the patient. Most of the spinal tuberculosis cases involve thoracic spine, and cervical involvement is unusual and rare. This case series is about different presentation and treatment approaches of cervical spine tuberculosis in four healthy young girls without any comorbidities. Among them, three girls presented with severe neurological complications. All of them had a history of severe neck pain and stiffness. None had constitutional symptoms or tuberculosis exposure. Diagnosis was made with the help of magnetic resonance imaging (MRI) spine and histopathological and microscopy of biopsied skeletal segments. The three girls with neurological complications were treated with surgical debridement and cervical spine stabilization surgery along with antitubercular treatment (ATT). All the three girls remarkably improved neurologically with a combined approach. The one without significant neurological deficits was started on ATT alone and advised to follow up with serial neuroimaging.