Fractures of the odontoid process in children are rare but account for the majority of all the cervical spine injuries in the infantile and young juvenile rnrngroups. The initial radiographic evaluation is often rndifficult so that the diagnosis-making is delayed or the fractures are missed. The management of the odontoid fractures of adults has long been controversial and varies with different spinal surgeons. By contrast, the diagnosis and treatment of odontoid fractures in skeletally immature children have not been frequently documented and not in details. This paper reviews the clinical characteristics, diagnosis, treatment principles, and long-term outcome of the odontoid fractures in a consecutive series of patients aged 14years or younger.