A 60-year-old man with cervical myelopathy due to Arnold-Chiari malformation and atlanto axial dislocation (AAD) who underwent mnltiple operations was reported. 20 years ago, he had undergone laminectomy of C1 and C2.5 years after the initial surgery, posterior cerviczl spinal fusion following laminectomy of C3 and C4 were performed. However, he complained of severe neck pain and gait disturbance' and visited our hospital. On the cervical X-ray, a broken wire and AAD (ADI 8mm) were observed. MRI examination revealed compressed spinal cord due to Arnold Chiari malformation type I. Occipito-cervical fusion with rest angular rod following decompression of Foramen magnum was performed. 6 months after the surgery, improvement of neck pain and gait disurbance was seen.