Stiff neck in children is a quite frequent sign of various pathological processes, not always benign in nature. Here is referred the case of a extradural cervical tumor in which stiff neck, associated with nucal rigidity, was for a long time the only symptom of the underlying process. The association of cervical tumor with stiff neck as the only longlasting initial symptom has only sporadically been reported. The authors analyse the various causes of stiff neck from the clinical and anatomo-pathological viewpoints, including age of patient at onset.