Serious complications of caliper skull traction for fracture-dislocations of the cervical spine are so rare that they are not discussed in most standard textbooks. A fusiform intracranial aneurysm which followed the placement of skull tongs is reported. Subsequent aneurysmal rupture produced an intracerbral hematoma requiring drainage. The literature recording the complications of skull caliper traction is reviewed and the indications for skull traction and the need for scrupulous surgical technique are emphasized.