Background and Objectives The atlanto-occipital (AO) joint is a true, innervated synovial joint with the potential to cause pain.

Methods A detailed description of an AO joint injection technique is provided, as none was found on review of the literature.

Results Using this technique, three illustrative cases provide preliminary evidence that intraarticular injection of the AO joint may have both diagnostic and therapeutic value for the treatment of upper cervical pain and headaches.

Conclusions Although AO joint injections may prove to be an effective adjunct to more traditional forms of conservative treatment, additional prospective studies are needed to better define the role of intraarticular AO joint injections in the diagnosis and treatment of head and neck pain.