[Objective] To compare the clinical efficacy of distraction reduction versus prying reduction combined with anterior corpec-tomy and instrumented fusion for locked low cervical fracture and dislocation. [Methods] A retrospective study was done on 128 patientswho underwent surgical treatment for locked low cervical fracture and dislocation from August 2014 to September 2019. According to conse-quence of the preoperative doctor-patient communication, 67 patients received distraction reduction (the DR group) , while the other 61 pa-tients underwent prying reduction (the PR group) . After reduction, all patients were treated with anterior corpectomy and instrumented fu-sion. Perioperative conditions, follow-up and imaging data were compared between the two groups. [Results] All patients in both groupswere successfully operated on. The early complication rate was of 8.96% (6/67) in the DR group, whereas 21.31% (13/61) in the RPgroup, which was not statistically significant (P=0.05) . There were no significant differences in operative time, incision length, intraoper-ative blood loss, intraoperative fluoroscopy times and hospital stay between the two groups (P＞0.05) . In addition, there were no significantdifferences in the time to remove external fixation and the time to resume full weight-bearing activity between the two groups (P＞0.05) .The ASIA sensory score, motor score and JOA cervical spine score in both groups significantly increased over time (P＜0.05) , which in theDR group were significantly better than those in the PR group at 6 months after surgery and the latest follow-up (P＜0.05) . Radiographical-ly, anterior cervical arc, local angulation and C2~C7 lordosis significantly improved in both groups at 6 months postoperatively and at the lat-est follow- up compared with those preoperatively (P＜0.05) . However, there were no statistically significant differences between the two groups in terms of abovesaid radiographic items at 6 months after surgery and the latest follow-up (P＞0.05) . [Conclusion] The distraction reduction is considerably more conducive to improvement of nerve function than the prying reduction for locked low cervical fracture and dislocation.