CT was used during the percutaneous needle biopsies of seven cervical spine lesions. Four were primary bone tumors, and there was one case each of metastasis, fibrous dysplasia, and infection. Two of the lesions were located in the lateral masses of C1 and one was in the pedicle of C2. The other four were in the lower cervical spine (C4-C6). Accurate diagnosis was obtained on the first attempt in six (86%) of seven cases. No complications were encountered. This experience suggests that needle biopsy performed with CT guidance is both safe and effective.