Rotary fixation of the atlanto-axial joint is a rare disorder in which the atlas gets fixed in a position normally achieved during rotation. A persistent asymmetrical position of the dens in relation to the atlas during head rotation is the clue to the diagnosis. Rotary fixation can be demonstrated by radiography/fluoroscopy and computed tomography (CT). However it is easily overlooked, largely by inattention. We present a typical case in an adult in whom the rotary fixation was demonstrated by radiography/fluoroscopy and CT.