Background: Pedicle screw fixation of lower cervical spine is a new technique that provides an alternative to posterior lateral mass plating. Although biomechanical studies suggest the use of pedicle screws to reconstruct the cervical spine, placing screw in small cervical pedicle poses a technical challenge. Penetreation of screw in pedicle is a primary complication associated with screw insertion in the lower cervical spine. Aim and Objective: To manage the cervical spine injuries by pedicle screw presented to department of Orthopaedics, BPKIHS, Dharan. Materials and methods: This is retrospective interventional study done at the department of Orthopaedics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal over a period of 2 years from March 2012 to April 20014. A total of 55 patients with cervical spine injuries were treated by pedicle screw. The patient's age ranged from 20 to 60 years and the mean follow-up was 12 weeks. Results: The study comprised of 55 patients with cervical spine injuries were treated by pedicle screw The age incidence in this series ranged from 20 years to 60 years. 40 patients were males and 20 was female. All had fractures or fracture dislocation at different levels of lower cervical spine. The mechanism of injury included falls from height (80%), motor vehicle accidents (18%) and sports related injury (2%). Discussion: Pedicle screw insertion into the pedicles in the lower cervical spine is technique that requires a solid knowledge of 3-dimensional anatomy of cervical spine and experience of pedicle screw fixation in thoracolumbar spine. The biomechanical advantages of pedicle screw fixation in cervical spine is obvious, but data are limited. However, safety and role of pedicle screw fixation in reconstruction in the lower cervical spine have not been defined. Conclusion: It is indicated in patients with osteoporotic bone or when rigid internal fixation can not be achieved by conventional techniques.