The roentgen evaluation of the cervical spine must be performed immediately following the possibility of injury and in such a manner as not to compromise the neurologic status of the patient. Subtle roentgen findings indicating ligamentous injuries must be recognized so that they can be treated prior to developing cervical spine instability. Occult fractures, which may be difficult to diagnose on plain films and require multiple radiographic modalities, must be diagnosed so as to prevent prolonged intractable neck pain. Most importantly, recognizing the mechanism of injury and prevention of cervical spine injuries are critical to prevent catastrophic cervical spine injuries secondary to athletic participation.