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Background: Injury to the cervical spine due to a scarfassociated accident has not been reported in the literature. We present a case of a hangman's fracture in a 43-year-old woman that resulted from a scarfrelated injury as a consequence of a motor vehicle accident., Purpose: To identify the mechanism of a scarf-related injury causing Hangman's fracture., Case Report: A 43-year-old woman was involved in a motor vehicle accident. She was wearing a scarf, which is a common clothing accessory for women in Malaysia. The scarf was violently torn off her head during the injury, causing a type I hangman's fracture. A halo vest for a total period of 3 months was applied., Conclusion: A scarf-related injury can cause an injury that resembles judicial hanging, leading to a traumatic spondylolisthesis of the axis. Careful evaluation of the cervical spine radiographs is crucial as occult fracture of the axis can be missed.