Objective To present the operative results of 17 patients with atlantoaxial diseases using transoral approach.Methods 17 patients received operation of atlantoaxial fusion using transoral approach.The average age is 27 years old(12～ 47 years).Results All patients had achieved primary healing without any complications.The fusion rate was 100% .The average recovery rate (JOA score system) of myelopathy was 48% .Conclusions Transoral approach was an ideal approach for upper cervical diseases.The infection rate could be lowered down to the minimum if the patients were properly managed perioperatively.Atlantoaxial fusion could be achieved through this approach without instrumentation.