The most important aspects of radiological diagnosis of acute cervical spine injuries (ACSI) below the level of C2 are presented. The major task of the radiologist is to determine, as soon as possible, the type, the extent, the level, and especially the clinical significance of the injury, i.e. to find out whether it is stable or unstable. The basis for correct radiological diagnosis is a solid knowledge of the usual and radiologic cervical spine anatomy and understanding of its functions and of various developmental variants and anomalies. Theoretical reconstruction of forces involved in the mechanisms of injury enables us to understand instability and the typical radiological signs. Modern radiology offers many highly accurate diagnostic modalities. Still, in the majority of unstable ACSI correct diagnosis can be made using routine series of six plain radiograms. Only if the diagnostic of instability is not obvious after the diagnostic step, more complicated investigations are used. Depending on the clinical problem, conventional tomography, computed tomography or magnetic resonance imaging are demanded in the next step. Being the only radiological diagnostic which estimates the effect of an injury on the cervical spine mobility, the functional views are still an important part of the radiological work-up of the ACSI.