Objective. To assess capabilities and advantages of endoscopic transnasal removal of pathological foci in the region of the C2 odontoid process. Material and Methods. The study included 3 patients who underwent endoscopic transnasal removal of the invaginated odontoid process accompanied by simultaneously (2 cases) or previously performed (1 case) occipitospondylodesis. Results. The pathological focus was totally removed in all cases. Postoperative complication occurred in one case – wound liquorrhea with subsequent development of meningitis which required performing plastic surgery of the CSF fistula. At follow-up examination, all patients presented with complete regression of symptoms. Conclusion. Endoscopic transnasal access allows for radical removal of pathological foci of the craniovertebral junction. Endoscopic transnasal approach will not be able to completely replace a transoral one, but it is a reasonable alternative in experienced hands. © 2019 Hirurgia Pozvonochnika. All rights reserved.