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Odontoid fractures constitute the commonest cervical spinal fracture in the elderly. There are varied management approaches with paucity of robust evidence to guide decision-making. We review the case of a 92-years-old man with traumatic Grauer type II B odontoid fracture treated with anterior cannulated screw fixation. Postoperatively, he was noted to have dysphagia due to a zenker's diverticulum. Further history revealed repair of a zenker's diverticulum ~40 years prior. Cervical spine images and video fluoroscopy demonstrated a recurre