Children are active by nature, and many developmental and injurious problems are difficult to detect without attention, or have already formed a fixed deformity by the time they are detected. Among these, it is common to encounter families bringing their children to the clinic asking why their child’s neck is crooked. Here are the most common causes. Congenital cervical tilt is a fibrous contracture of the sternocleidomastoid muscle on one side, resulting in a deformity that tilts the neck and head to the affected side. The cause is fibrosis of the sternocleidomastoid muscle due to various reasons, and the gradual contracture leads to the appearance of a strabismus. The causes and fibrosis are not well understood. Most scholars believe that breech delivery, birth injury and pulling and other factors lead to sternocleidomastoid muscle injury bleeding, hematoma mechanization, contracture and formation. Clinical manifestations of the baby after birth, unintentionally found on one side of the sternocleidomastoid muscle mass, 2 ~ 3 weeks the mass gradually become hard, inactive, pike-shaped, the size of a finger. About half a year, the mass gradually subsided, but the sternocleidomastoid muscle fibrous contracture, shortening, showing a cord, pulling the occipital and biased towards the affected side, the jaw turned to the healthy shoulder. With growth and development, both sides of the face are asymmetrical, the healthy side is full, the affected side becomes smaller, and both eyes are not at the same level, and in severe cases, cervical scoliosis can be secondary to cervical spine deformity. According to the clinical manifestations, the affected side of the sternocleidomastoid muscle is contracted in the form of a stripe, and the head and face are tilted, which makes the diagnosis of myoclonic cervical tilt clear. However, differential diagnosis is very important: 1, bony tilt neck, cervical spine abnormalities such as atlantoaxial subluxation, half vertebrae, etc., the sternocleidomastoid muscle is not contracture, X-ray examination can be diagnosed. 2.Inflammation of the neck with enlarged lymph nodes, localized pressure pain and systemic symptoms, no contracture of sternocleidomastoid muscle. 3.Ocular muscle abnormality The muscle strength of extraocular muscles is unbalanced, and patients with strabismus coordinate their vision with neck deviation. Early detection and early treatment are recommended for treatment. Late-stage strabismus can be corrected surgically, but other tissue abnormalities (such as facial asymmetry, cervical scoliosis) are difficult to return to normal. 1.Manipulative corrective treatment: after the diagnosis of the newborn, gentle massage and hot compresses every day, passive pulling by manipulation, moderately to the healthy side of the head, several times a day, each time 10~15. When sleeping, sand pillows should be used for immobilization. With the growth of the child, manipulation of the trigger to increase the strength of the occipital rotation to the healthy side, the jaw to the affected side, several times a day to trigger, perseverance, most of the results can be satisfactory. 2, surgical treatment: suitable for children over 1 year old, generally use the proximal end of the clavicle on a transverse finger, make a transverse incision, for children aged 1 to 4 years old, the condition is mild, only cut off the clavicular head of the sternocleidomastoid muscle and the sternal head, the application of the postoperative neck collar to maintain and slightly over the corrected position, and often to the affected side of the child’s lower jaw, the occipital rotation to the healthy side. For those who are over 4 years old and have severe strabismus, upper and lower sternocleidomastoid muscle cutting and releasing is feasible. In cases with soft tissue contracture, an incision is made along the sternocleidomastoid muscle from the mastoid process, and all tense soft tissues are removed until the muscle is completely released. The wound is sutured, the head is placed in a slightly overcorrected position, and the head, neck and chest are immobilized in a plaster cast for 4 to 6 weeks, and after removing the cast, passive head pulling exercises are performed. During the operation, care should be taken not to damage the phrenic nerve, common carotid artery and external jugular vein; the facial nerve passing under the ear should be avoided to be damaged when doing the superior cut-off and release operation.