Introduction: Sagittal balance was measured by Hardacker`s et al. using the occipital method COBB C1-C2, C2-C3, C3-C4, C4-C5, C5-C6, C6-C7 in a sample of asymptomatic patients without neck and shoulder pain. In other recent studies, measurements of cervical sagittal balance included several radiographic parameters. Objective: To compare the cervical sagittal balance in groups of patients with and without neck pain submitted to cervical radiography with the upper limbs in flexion. Methods: This is a cross-sectional, quantitative, prospective, descriptive study with radiographic analysis of 50 adults aged between 30 to 70 years old. The group was divided into Group 1: without neck pain, and Group 2: with neck pain. All answered a questionnaire about age and the presence or absence of neck pain. Exclusion criteria were: inadequate X-Ray image, deformity or previous spine surgery, limited shoulder mobility, and individuals younger than 30 and older than 70. The radiographic parameters evaluated were: COBB, TIA ( THORACIC INLET ANGLE), T1 SLOPE, NECKTILT, and COG-C7 with no neck pain. α = 5% (significance when p <0.05). Results: The MANN WHITNEY nonparametric test showed no significant differences between Cobb GROUPS (p= 0.7452), T1 SLOPE GROUPS (p=0.1410), NECKTILT GROUPS (p=0.0852) and GROUPS THORACIC INLET ANGLE (p=0.1789). Conclusion: There was a significant difference only between COG-C7 GROUPS (cm) (p=0.0013). The analysis of the obtained data showed statistical significance in the variation in the COG-C7 groups. Level of Evidence II; Prospective comparative study.