In brief: This article presents two case reports of fractures of the cervical spine that occurred during a lacrosse game. Both injuries occurred to midfielders during a face-off. One player was charging into the face-off, and the other was charged during a face-off. Both had their heads down. The author suggests several ways that might prevent future cervical spine fractures in lacrosse, including a rule change that would not allow a player to be so vulnerable during a face-off or ground ball, ejecting a player for spearing or blindsiding, and alerting lacrosse coaches and sports medicine departments of the danger of spearing in lacrosse.