Rotatory subluxation of the atlantoaxial joint in adults is a rare, but potentially life-threatening injury. Delayed or missed diagnosis can lead to catastrophic consequences. Early recognition and prompt treatment is paramount to avoid long-term morbidity and disability. We report on an instance of bilateral atlantoaxial rotatory subluxation (AARS) in a 25-year-old female who presented to the Casualty Department with a painful neck, right-sided hemiparesis and torticollis after a road traffic collision. Reduction was achieved by controlled cervical traction followed by immobilization in a four-post Halo brace, with complete resolution of her symptoms. At the 12-month follow-up, she had normal neck movements with no signs of instability.
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