
Background: Ponticulus posticus is a cervical spine anomaly which can be detected on a routine lateral cephalogram that is mostly neglected by the dentists. Aims: To estimate the prevalence of ponticulus posticus and its relationship with gender in Central Kerala population. Methods and Materials: A sample of 525 patients lateral cephalogram were randomly selected from the archived records in the department. Eighty one lateral cephalograms were excluded, and only 444 lateral cephalograms were taken with patients aged between 8-50years. Each digital radiograph was inspected for the presence and absence of ponticulus posticus. It was further evaluated for either partial or complete form and the results were statistically analyzed. Results: Ponticulus posticus was observed in 32% of the patients, of which 3.8% had complete and 28.2% had partial type. Even though there was some male predilection, no statistically significant association was found between gender of the patient and presence of ponticulus posticus. Conclusion: Ponticulus posticus is a common anomaly; therefore, lateral cephalogram should be carefully examined to check for the presence of this anomaly.