STUDY DESIGN: A case study was conducted. OBJECTIVE: To detail the successful nonoperative management of a distraction-flexion Salter-Harris Type 1 midcervical spine injury in a young child. SUMMARY OF BACKGROUND DATA: Documented cases of neurologically intact pediatric patients with unstable flexion-distraction injuries of the midcervical spine are rare. METHODS: A case report and literature review are presented. RESULTS: A rare distraction-flexion injury was successfully treated nonoperatively. CONCLUSIONS: Although distraction-flexion cervical spine injuries are common in adults and often occur with concomitant neurologic sequelae, they also can occur in the pediatric patient. Whereas these injuries require surgery in adults, they can be managed nonoperatively in the pediatric population.