Bilateral traumatic abducens nerve palsy is a rare condition. Here a case without skull fracture and associated with cervical spine fracture is reported. Only two cases like this were found in a review of the literature. The mechanism of the lesion is discussed in light of the two main theories proposed thus far. When the injury is acute, as happens in the majority of cases, the nerve lesion probably is due to contusion and stretch of the nerve trunk against the ridge of the petrous bone and the rigid dural hole of entrance in the extradural space at the basilar process.