BackgroundInjury to the spinal accessory nerve [SAN] results in a debilitating shoulder dysfunction. Iatrogenic injury is common during radical neck dissection, cervical lymph node biopsy, and other surgical procedures; thus the superficial course of the nerve in posterior cervical triangle [PCT] makes it susceptible. The anterior cervical triangle [ACT] is an unusual location for iatrogenic SAN injury.FindingsWe present a case that outlines the risk of SAN injury following a surgical operation in the ACT.ConclusionsPrevention of inadvertent injury to the SAN is also critical in the ACT, as well as in the PCT section.