Mirror movements is a congenital disorder of motor control in which voluntary movements initiated in one arm or leg are copied by the other. Usually children with this syndrome have no other evidence of neurological disease and improve as they grow older, although some degree of synkinesia may persist. It is hypothesized that the critical pathologic feature is a failure of adequate decussation of the pyramidal tracts or dorsal closure of the cervical cord. It appears that failure of the pyramids to ducussate forces patient to use extrapyramidal pathways to initiate movement, which in the absence of the inhibitory influence of pyramidal fibers gives rise to bilateral activity. The Klippel-Feil syndrome is characterized by a congenital failure of cervical segmentation resulting in apparent fusion of two or more cervical vertebrae. A 7 year old boy with mirror movements and klippel deformity is described.