Abstract [Objective] To explore the curative effect of anterior cervical discectomy and fution(ACDF) in the treatment of unstable Hangman fracture. [Methods] Sixteen patients with unstable Hangman fracture were followed up . All patients were treated with ACDF plus plate fixation from March 2006 to March 2016.The operative time,intraoperative blood loss,postoperative drainage and surgical complications were recorded.Patients were followed at 3 days,1,3,6,12,24,36 months after operation.The effectiveness were evaluated using VAS scorre,NDI index and ASIA classification.Cervical?curvature,fracture healing and interbody fusion rates were evaluated.[Results] The average operation time was (92.3±8.16) min，ranged from 85 to 125 min.The average intraoperative blood loss was (71.6±4.37)ml，ranged from 50 to 120 ml.The average postoperative drainage was (30.2±2.42) ml,ranged from 20 to 40 ml.All patients were followed up for (24-36) months, average 26.3 months.The VAS and NDI scores were significantly improved from (6.0±0.69) and(24.82±1.96) preoperative to (1.08±0.13) and(4.88±2.35) at 24 months postoperation.The difference was statistically significant (P < 0.05).The imaging examination showed that the physiological curvature of cervical spine recovered to normal at 24 month and C2/C3 achieved bony fusion. The?movement?function?of?bending,?extending?and?rotating were recovered.[Conclusion] For unstable Hangman fracture, ACDF has?the?advantages?of?minimal?invasion,?less?bleeding,?can effectively restore cervical curvature and reconstruct cervical stability，and?the?effect?is?positive.