Objective To introduce a technical innovation for the treatment of severe multi-level thoracic ossification of posterior longitudinal ligament (OPLL). Methods The detailed surgical procedure included isolation of vertebra-OPLL complex (VOC), implantation of screws and rods, and antedisplacement of the VOC. A patient diagnosed as multi-level thoracic OPLL with myelopathy was treated by this technique and the outcomes were reported. Results Neurological outcomes achieved an evident improvement, with the recovery rate of modified-Japanese Orthopaedic Association score being 75%. The operation took 480 min and the intraoperative bleeding was 1 000 mL. Postoperative computed tomography and magnetic resonance imaging showed sufficient decompression of spinal cord. The occupation ratio of spinal canal improved from 86.6% to 58.8% in T_2/3, and from 68.2% to 45.9% in T_3/4. Conclusion Posterior thoracic vertebra-OPLL complex antedisplacement and fixation is a feasible, theoretically safe and effective surgical option for the treatment of severe multi-level thoracic OPLL with myelopathy. The operation is simple and performed outside the spinal canal, and no ossified mass is removed. However, further studies with large-scale cases and control groups are required to reveal the applicability and safety of this technique.