Abstract Background: Acute subaxial cervical spine injuries fol-lowing trauma remain a common problem. These injuries are often associated with neurological deficits on presentation. Individual subaxial cervical spine injuries represent a wide spectrum of damage to the anatomic structures of the neck, including fractures, ligamentous injury, and disk disrup-tion, often with injury to the cervical spinal cord and nerve roots. Several authors have reported series of patients treated with a combination of anterior and posterior decompression, but they did not differentiate outcomes between the anterior standalone and anterior and posterior techniques. Aim of Study: The aim of the study to present clinical and radiological outcomes of patients who were operated by combined anterior-posterior approach for unstable subaxial cervical spine injury. Patients and Methods: The study included the 40 patients admitted to emergency unit of Neurosurgery Department at Cairo University from 2016 to 2018 and operated with this procedure. Results: Improvement of the neurological state occurred only in 15 patients with percentage of 37.5%. Other 25 patients showed no improvement with percentage of 62.5%. Conclusion: Circumferential stabilization and fusion in unstable subaxial cervical spine fractures gives an opportunity for the complete posterior and anterior de-compression of the cervical cord providing good results in alignment, fusion, and neurological recovery, we could not find any absolute con-traindication for a combined approach in our study.