Injuries of the cervical spine in adolescents only occur in 0.2 % of cases. Due to the mismatch of size of the head in comparison to the relatively weakly developed neck muscles at this age, the cranial section is more vulnerable to injuries of any kind compared to the lower sections of the cervical spine. In children isolated ligament trauma is more common than fractures due to the relatively good bone structure combined with a lower bone density but the risk for fractures increases with the age of the patient. Atlantoaxial dislocation (AAD) in children is a very rare mostly ligamentous injury. A differentiation is made between traumatic AAD and the much more common non-traumatic AAD described in the literature. Although the cause is still unknown different risk factors have been isolated that seem to increase the risk for non-traumatic AAD. The following article presents guidelines for the diagnosis and treatment of this rare type of injury and also describes the case of a 19-year-old female who presented at the emergency department with an AAD without a history of trauma. After successful closed repositioning the neck was stabilized in a semi-rigid cervical collar for 6 weeks.