Abstract：Objective：To observe the clinical effect of flexible bone setting on atlanto-axial subluxation. Methods：A total of 80 cases with atlanto- axial subluxation were randomly divided into two group. The control group was adopted with conventional three- step treatment including spasmolytic and muscle- loosing method， reconstructive dislocation method， sinew-reinforcing and collaterals-normalizing method. The treatment group was adopted with four-step treatment of flexible bone setting. The clinical effect， cervical spine score of JOA， difference of DR atlanto- dental interval， difference of DR variance of bilateral lateral atlanto dental space，score of clinical symptoms and signs，and the recurrence rate after half a year of follow-up were all observed and compared between the two groups. Results：The total effective rate was 97.5% in the treatment group and 87.5% in the control group，the difference being significant(P＜0.05). After treatment，there were significant differences in the comparison of JOA score， difference of DR atlanto- dental interval， and difference of DR variance of bilateral lateral atlanto dental space when compared with those in the same group before treatment(P＜0.05). After treatment，there were significant differences in the comparison of the above indexes between the two groups(P＜0.05). After treatment，there were significant differences in the comparison of scores of clinical symptoms between the two groups(P＜ 0.05). After treatment，there were significant differences in the comparison of scores of body signs between the two groups (P＜0.05). After six-month follow-up，there was significant difference in the comparison of the recurrence rate between the two groups(P＜0.05). Conclusion：Flexible bone-setting has great clinical effect in treating atlanto-axial subluxation，which can improve JOA score， difference of DR atlanto- dental interval， and difference of DR variance of bilateral lateral atlanto dental space，whose effect is better than the common three-step treatment.