We report the use of a novel plate and screw system for posterior occipitocervical fixation in a case with neurological deficit due to basilar invagination. Using this technique, a more rigid fixation than sublaminar wiring can be achieved. In addition, upper cervical vertebrae which are laminectomized for decompression can be stabilized without the risk of cervical spinal canal narrowing due to sublaminar wiring. We discuss the importance of posterior occipitocervical stabilization and emphasize the advantages of using the plate and screw system.