The upper cervical region has a unique and complicated anatomical structure due to the transition region between brain stem and spinal cord, vertebrobasilar junction and lower cranial nerves. The occipito-atlanto-axial region, called the upper cervical region, consists of the atlas and axis connected to the occipital bone by ligaments and the neurovascular structures in this region. It allows three-dimensional head movement (flexion, extansion, rotation and lateral bending). C1 vertebrae consists of the anterior and posterior arches and lateral masses, and has no corpus. C2 consists of the odontoid process, vertebral corpus and superior articular facets. The lower facet of C1 and the upper facet of C2 come together to form the facet joint. Since there is no intervertebral disc between C1 and C2, the facet joints and ligaments provide the stability and movement of the upper cervical region. Instability of the atlantoaxial joint causes severe neurological deficits due to spinal cord compression. Many techniques such as cervical orthosis and halo applications, pedicle, laminar and transarticular screw fixation, C1-C2 wiring, sublaminar hook have been described for stabilization of the atlantoaxial joint.