Nine atlanto-occipital dislocations were found in postmortem examinations of 112 victims of multiple trauma. Axial traction facilitated roentgenographic identification of the injury. A hyperextension mechanism of injury was suggested by the associated injuries, including submental lacerations and mandibular fractures. Atlanto-occipital dislocations were more frequent in children than in adults. A pure dislocation injury without fracture was identified.