A fracture of the cervical spine is a dangerous and life-threatening injury in patients suffering from ankylosing spondylitis. A 71-year-old motorist with a long history of ankylosing spondylitis was injured during a car accident. A rare transverse fracture through the body of C6 occurred and in addition a lesion of the trachea was found. This combination of injuries is described for the first time. Special problems relating to the initial rescue, diagnosis and treatment are discussed according to the literature. The necessity of handling the cervical spine with extreme caution during all medical procedures, taking into account the kyphotic deformity is stressed.