Three patients requiring transoral transpalatal odontoidectomy were reviewed. Two were unstable and had compressive signs secondary to type II odontoid fracture and rheumatoid artritis, respectively. The third had a basi-lar invagination and was stable before transoral odontoidectomy but has developed instability in the early postoper-ative period. Patient with rheumatoid disease had immediate respiratory arrest although a successful posterior fu-sion and stabilization with Luque instrument was performed in the previous operation. Other two cases improved and discharged with minör deficits.