Osteochondroma of the cervical spine is an uncommon manifestation of a common bony tumor. A case is reported of a lesion arising from the base of the spinous process of C2. Review of the literature provided data related to the cervical spine level and location within the cervical vertebral body of 11 additional osteochondromas in patients under 18 years of age. Analysis demonstrated a significant correlation between osteochondroma distribution and the known occurrence of primary bone centers.