1. A case of fracture-dislocation of the atlas on the axis is presented in which the neck had been manipulated under anaesthesia for "rheumatism."

2. Despite marked displacement there were no important neurological complications.

3. One-stage reduction by traction was carried out very slowly and with radiographic control. It is believed that this is less distressing to the patient, and safer, than gradual reduction by prolonged traction.

4. Because of the instability of the atlanto-axial joint after reduction surgical fusion of the upper cervical spine to the occipital bone is advisable.

5. In the case now reported recovery was complete.