Objective To compare the dinical outcome of posterior Gallie method with cable fixation and Harms technique with C1,2 pedicle screw fixation in treatment of odontoid fractures. Methods From July 2003 to July 2008, 26 patients with types Ⅱ and Ⅲ odontoid fractures were treated surgically. There were 18 males and 8 femalses, at age range of 22-65 years ( average 43 years). The patients were divided into Gallie titanium cable fixation group (Gallie group, n = 14) and C1 -C2 posterior screw fixation group using Harms technique (Harms group, n = 12) according to treatment methods to compare blood loss, operation duration, costs, hospital stay, bone fusion time, complications and secondary operation. Results The patients were followed up for 18-84 months ( average 37.3 months). The average blood loss and costs in Gallie group were significantly less than that in Harms group (P<0.05), while the time for back to work in Gallie group was significantly longer than that in Harms group ( P < 0. 05 ). There was no statistical difference upon operation duration, hospital stay and bone fusion time in two groups (P > 0. 05 ). There was one patient with nonunion and two with delayed union in Gallie group and one with secondary operation due to implant failure in Gallie group, and one with secondary debridement due to wound infection and one with delayed wound healing in Harms group, with no statistical difference (P > 0. 05). Conclusions Both Gallie technique with titanium cable fixation and Harms C1,2 screw fixation have advantages of early walk and short hospital stay. Compared with the former, the latter technique costs more but can help early back to work.