A 42-year-old woman presented to the neurosurgery clinic with neck pain. She exhibited short neck, low posterior hairline, and limited neck movement. She had a normal neurologic examination. Magnetic resonance imaging and computed tomography revealed multiple congenital fusions of the cervical (C5–C7) and upper thoracic (T1–T3) vertebral body (Fig. 1, Fig. 2). Multiple hemivertebrae and butterfly vertebrae were also determined by magnetic resonance imaging (Fig. 1). Klippel-Feil syndrome with butterfly vertebrae is very rare but has been reported [ [1] Rahimi-Movaghar V. Moghtaderi A. Shahriarian S. Keshmirian B. Klippel-Feil anomaly associated with thoracic hemivertebrae/butterfly vertebrae and patella hypoplasia. Clin Dysmorphol. 2004; 13: 39-41 Crossref Scopus (3) Google Scholar ]. Fig. 2Three-dimensional volume-rendering computed tomographic (CT) image shows multiple congenital fusions of the cervical and upper thoracic vertebral body. View Large Image Figure Viewer Download Hi-res image