The authors describe their experience with 30 cases of atlanto-axial dislocation over a period of 3 years and 9 months, using a modified plate and screw method for fixation of the lateral masses of the atlas and axis. The technique achieved a 100% union rate with no morbidity, mortality, or instrument fatigue or failure. The average follow-up period was 19 months. The method provided immediate rigid segmental internal fixation, allowing early mobilization with minimal external support. Onlay and interfacetal bone grafts subsequently facilitated bony fusion. The direct application of screws to the atlas and axis, utilizing the firm purchase in their thick and large cortico-cancellous lateral mass, ensures biomechanically strong fixation. The technique can also be modified to achieve occipito-cervical fusion in selected cases, particularly in complex congenital or traumatic craniocervical region instability where conventional methods have failed or are not suitable. The authors review the technical aspects and merits of this method, emphasizing its potential utility in various clinical scenarios.The authors describe their experience with 30 cases of atlanto-axial dislocation over a period of 3 years and 9 months, using a modified plate and screw method for fixation of the lateral masses of the atlas and axis. The technique achieved a 100% union rate with no morbidity, mortality, or instrument fatigue or failure. The average follow-up period was 19 months. The method provided immediate rigid segmental internal fixation, allowing early mobilization with minimal external support. Onlay and interfacetal bone grafts subsequently facilitated bony fusion. The direct application of screws to the atlas and axis, utilizing the firm purchase in their thick and large cortico-cancellous lateral mass, ensures biomechanically strong fixation. The technique can also be modified to achieve occipito-cervical fusion in selected cases, particularly in complex congenital or traumatic craniocervical region instability where conventional methods have failed or are not suitable. The authors review the technical aspects and merits of this method, emphasizing its potential utility in various clinical scenarios.