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Objective— To present a detailed description of a dog with atlanto-occipital (A–O) luxation, including results of the neurologic examination, diagnostic imaging, and treatment by closed reduction.

Study Design— Clinical case report.

Sample Population— One adult intact male German shepherd dog.

Results— Neurologic signs included nonambulatory tetraparesis and neck pain. An apparent hypoglossal nerve deficit was consistent with a lesion at the peripheral part of the nerve in the region of the craniocervical junction. Radiographic examination revealed a left-sided luxation of the A–O joint, and fractures were excluded with the aid of computed tomography (CT). Closed reduction of the luxated articulation resulted in a stable A–O joint, and complete neurologic recovery occurred within 4 weeks.

Conclusions— Hypoglossal nerve deficits may be associated with A–O luxation.

Clinical Relevance— Closed reduction of a unilateral, traumatic luxation of the A–O joint is a therapeutic option in dogs. CT imaging, especially 3-dimensional reconstruction, was considered helpful in excluding fractures as well as defining treatment options.