Examining the cervical spine in children may be difficult, especially if they are too young to articulate their complaints or if they are frightened or in pain, and the physician often has to rely on subtle clues and multiple physical examinations at different times to obtain a diagnosis. When evaluating a child, one must consider that the growing spine has a somewhat different anatomy than that of an adult, and a sound knowledge of the stages of development is required. For example, children under the age of 8 years have increased neck motion compared to adults. In addition, familiarity with the types of dysplasias or other congenital anomalies is necessary because often symptoms in the spine are associated with a variety of syndromes. This chapter discusses the development and anatomy of the cervical spine in children and provides an in-depth discussion about the presentation of cervical disorders and the physical examination necessary to arrive at an accurate diagnosis.