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The suboccipital muscles are a group of 4 muscles located in the posterior region of the neck, inferior to the occipital bone. These 4 muscles are the rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, and obliquus capitis inferior (see Image. Deep Posterior Neck Muscles). The muscles serve as postural support of the head and neck and allow neck extension and rotation movements. The muscles are innervated by the suboccipital nerve, which is formed by the dorsal ramus of C1. Three of the 4 muscles form the suboccipital triangle. This common anatomic landmark localizes the vertebral artery and suboccipital nerve (see Image. Nerves of the Posterior Head and Neck Region). This landmark is particularly important to surgeons operating in the posterior cervical region to avoid life-threatening bleeding. The vertebral artery takes a torturous course behind the suboccipital muscles while giving off branches that supply the suboccipital muscles. Clinically, the suboccipital muscles are important because of their close relationship to the vertebral artery and surgical access to the posterior cranial fossa. Various cranial pathologies can be accessed by a suboccipital surgical approach that requires knowledge of the posterior cervical region. The 4 muscles have been implicated in the pathogenesis of cervicogenic headaches due to their connections with the dura mater.