EDs each year with potential cervical spine (C-spine) injury, prompting approximately 800,000 C-spine radiographs. C-spine or neck radiographs are often useful in evaluating non-traumatic conditions commonly presenting to the ED. C-spine injuries are present in only 2% to 6% of blunt trauma victims and in even fewer non-traumatic ED patients, but the potential for catastrophic outcomes of missed C-spine injuries has led to a high index of suspicion by emergency physicians. C-spine injury is relatively uncommon in the pediatric population; however, rates of mortality and neurological damage are alarmingly high. The pitfall of pediatric C-spine radiography lies in the condition known as spinal cord injury without radiographic abnormality. A growing body of evidence and an increasing amount of authorities are now advocating a shift to computed tomography (CT)-based screening of blunt trauma victims for C-spine injury. CT has been shown to be up to 100% sensitive in multiple studies.