It is known that free-falling accident is one of the major causes of head or spinal injury, especially in the elderly and children. But, the frequent injury types are diverse according to the reports because of the different subjects studied among the reports. A cranio-spinal injury caused by free-falling accident from height hasn't been studied a lot in Korea yet. To evaluate the clinical aspects of cranio-spinal fracture caused by free-falling injury which developed particularly in a certain fixed place, we analyzed 122 patients who had had the fractures involving extremities, ribs, and cranio-spinal regions during the past 4 years from January 1994 through July 1997. Forty-seven patient(38.5%) had the cranio-spinal fracture. The incidence of the skull and vertebral body fracture were significantly higher than that of the vertebral transverse process fracture, respectively (p=.052 and p=.007). There was statistically insignificant in the height of falls between the skull and vertebral body fracture(p=.175). Associated extra- craniospinal fractures were noted on radius(25.4%), rib(20.5%), femur(9%), calcaneus(5.7%), and pelvic bone(4.9%), in order of frequency.