Objective To summarize our experience in using Smith-Robinson approach (SRA) for level C2/3 cervical spine surgery. Methods The clinical data of 36 patients receiving SRA for level C2/3 cervical spine surgery were retrospectively analyzed. The patients included 25 males and 11 females, with an average age of (47±13.5) years(range: 21-72 years). Thirty-five cases had Hangman fracture and one had traumatic disc herniation at C2/3. Combined injury included head injury (10 cases), soft tissue injury on the face (22 cases), fracture at lumbar spine (1 case), extremities fracture (6 cases) and injury of inner organs (2 cases). One patient had ankylosing spondylitis. Results C2/3 discetomy procedures were performed satisfactorily in all the 36 cases, with cages plus anterior plate fixation used in 34 cases and iliac bone plus anterior plate fixation in 2 cases. The patients were followed up for (9.1±2.8) months (ranging 6-32 months). One patient (2.4%) had choking and trouble in swallowing liquids, and the symptom disappeared 3 months later without any treatment. Neurological dysfunction was observed in 10 cases before operation, with the average JOA scope being (13.10±3.35) pre-operation and (15.70±1.49) post-operation, showing an improving rate of (74±23)%. Fusion was achieved in all cases during follow-up. Conclusion SRA can be applied at level C2/3 cervical spine surgery; the procedure is simple, with clear surgical field and less complication. Patients with large chin or extremely strong muscle may not be indicated for this approach.