&NA;Although the transoral approach to the atlantoaxial region is generally an open surgical procedure, in patients in whom only tissue diagnosis is required, a needle biopsy can be done. In this paper a patient with a metastatic lesion in the second cervical vertebral body is presented, and the technique for needle biopsy of the second cervical body using stereotactic methods is described. (Neurosurgery25:999‐1002, 1989)