Background: The halo vest is widely used throughout the world to manage craniovertebral and cervical instabilities. It can be used for postoperative immobilization or as an alternative to surgical fixation.Method: In this paper we present some cases of severe complications from our own practice and review the literature on halo complications.Results: Like any therapeutic manoeuvre, halo placement may be followed by various complications. In the meantime, modern techniques of fixation offer safe and immediate stabilization.Conclusion: The halo vest remains a formidable method for cervical immobilization. However, it should not be used a priori instead of surgery.