The halo skeletal device commonly is used both as primary treatment and as an adjunct to internal fixation in patients with cervical spinal injuries. For optimal outcome, the multidisciplinary team should have a basic understanding of the indications, design rationale, and complications associated with the halo skeletal fixator. Literature review. The halo device provides the most rigid form of external cervical immobilization. Adherence to established application guidelines is critical to minimize morbidity. Safe zones for pin placement have been delineated. Protocols for management of pin-site infections have been established to appropriately manage these unfortunate complications. Although the halo is an effective form of cervical immobilization, complications with its use are encountered periodically. Familiarity with the design rationale, proper method of application, and potential complications can help to minimize the morbidity of this commonly used device.