Objective To evaluate the feasibility of bilateral anterior cervical pedicle screw plate system (ACPS) fixation using liner and angular measurements of subaxial cervical transverse CT and MR images. Methods The images of normal lower cervical vertebrae from 50 males undergoing CT scan of cervical spine from Feb. 2016 to Jan. 2017 in the Naval General Hospital were included, and 38 cervical transverse T₂WI images from the above-mentioned males were collected. The distance between optimal entry point and midline of vertebral body (DOM), length of cervical pedicle axis (CPA), outer pedicle width (OPW), actual screw trajectory (AST) at ipsilateral side (adjusted entry point was -2.5 mm away from midline of vertebral body at ipsilateral side, based on the assumption that radius of nut of 3.5 mm diameter pedicle screw was 2.25-2.50 mm), available trajectory width (ATW), pedicle transverse angle (PTA) and trajectory transverse angle (TTA) were measured based on transverse CT images (bone window). The distance between vertebral artery and cervical pedicle (DAP), distance between spinal cord and cervical pedicle (DCP), and diameter of vertebral artery (DVA) were measured based on transverse MR images. Results There were no significant differences in same measurement parameter between left and right sides at same cervical level, and then the left and right measurement data of the same parameter and same sequence were combined for subsequent analysis. The OPW was significantly higher than APW, and PTA was significantly higher than TTA from C₃ to C₆ (all P<0.05). We defined 4.5 mm width as safety limit for pedicle non-perforation, 20%, 18%, 17%, and 8% of OPW and 70%, 64%, 38% and 29% of APW from C₃ to C₆ failed to satisfy the criteria. Due to the presence of DAP and DCP, non-critical ACPS displacement (2.9 and 4.4 mm, respectively) might be asymptomatic. The minimum value of ATW at C₇ level was 5.6 mm. Conclusion The penetrating rate is high when bilateral ACPS is used in subaxial cervical pedicle, and the non-critical perforation may have no clinical symptoms due to the presence of DAP and DCP.