Objective:To report two cases of microendoscopically assisted anterior screw fixation for the Type Ⅱ odontoid fracture.Methods:Casel(male,58-year-old) and case2(male,47-year-old) were operatively managed for the Type Ⅱ odontoid fracture.The operation was performed under immobilization of cervical spine using skull traction,and odontoid fracture was reduced.A skin incision 2 cm long was made on the medial border of the right sternocleidomastoid muscle at the C4C5 intervertebral level.Blunt dissection between the neurovascular bundle laterally and the trachea and esophagus medially was performed.A tubular retractor with slope bottom was placed after a series of dilators were inserted one by one.This retractor kept the minimum but sufficient space for the screw fixation and avoided esophageal complication.Using a cannulated screw system,a cancellous screw was inserted from the anteroinferior edge of the C2 vertebralbody to the tip of the odontoid process.The entry point was monitored by endoscopy to avoid soft tissue involvement.The insertion of guide thread and drilling as well as the screwing process was monitored by the "C" arm fluoroscopic guidance.