Sixteen cases of double level fracture of the cervical spine treated at the Orthopaedic Clinic of Athens University from 1970 to 1983 are presented. These comprise 5.5% of all cervical fractures. The aetiology, mechanism of injury, neurological complications and management of these injuries is discussed. Awareness of double level fracture in the cervical spine will alert the clinician to a more careful examination allowing earlier diagnosis and treatment of these injuries. The problems in management are stressed.