We present a unique case of crowned dens syndrome (CDS) that developed after 
endoscopic retrograde cholangiopancreatography (ERCP) in a patient who presented 
with fever and neck pain. Administration of non-steroidal anti-inflammatory 
drugs was extremely effective for relieving fever and neck pain, and in the 
improvement of inflammatory markers. To the best of our knowledge, this is the 
first case report of CDS caused by an ERCP procedure. In a patient with fever 
and neck pain after an ERCP procedure, CDS should be considered in the 
differential diagnosis.