This article reports the diagnosis and treatment of a case of trauma of the neck caused by a car accident. 59-year-old male patient was admitted to the clinic with "trauma from a car accident for 6 hours and dyspnea for 4 hours". Preoperative CT showed that there were mixed density foci in the posterior pharyngeal space in the segment of C1 upper edge-T2 upper edge, the adjacent posterior laryngopharyngeal wall and esophagus were compressed, and the corresponding laryngopharyngeal lumen was narrowed. Tracheotomy was performed first to relieve respiratory distress, and then hematoma removal in the retropharyngeal space was performed through the external cervical approach under general anesthesia. The tracheal tube was removed after the operation and the patient was discharged from the hospital. After the operation, the patient"s respiration and phonation were normal, and the prognosis was good.