[Objective] To introduce the surgical technique and primary clinical outcomes of occipital bicortical screw fixation in occipitocervical fusion. [Methods] From October 2010 to June 2019, 16 patients with occipitocervical instability received occipitocervical bicortical screw fixation and fusion. Among the procedure, the trajectory was drilled perpendicular to the external occipital protuberance for the specified depth with a depth-limited drilling, 2mm away from the internal bone plate, then the trajectory was deepened at interval of 1mm each time and a probe was used to explore all the walls of the trajectory. Bicortical screws of 3.5 mm in diameter and 20 mm in length were inserted to the occipital plate and the depth of penetration was less than 2mm to the internal bone plate. [Results] The operation were successfully, with an average follow-up time of 21.44±6.18 months, and there were no major complications during the perioperative period. The bone fusion was achieved in the last follow-up. JOA score was increased from 8.87±2.37 to 12.88±1.73, and VAS score was improved from 6.19±1.13 to 2.38±1.32 (p <0.05). [Conclusion] Posterior occipital plate combined with bicortical screw is a safe and effective surgical technique for occipitocervical instability.