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Acute injuries of the upper cervical spine as a cause of severe disability and death following trauma has at all times been an interesting phase of anatomical study. The present case study describes a rare outgrowth from the left transverse process of the atlas vertebra. This process referred to as epitransverse process can be of high importance to many specialties and especially to surgeons performing radical neck dissections, radiologists for accurate diagnosis of bony malformations and manipulative therapists, as it may markedly influence the posture, stability and mobility at the atlanto-occipital joint.