The invention relates to a medical instrument, in particular to an axis odontoid screw sighting device for guiding positioning of hollow screws during axis odontoid fracture treatment. The axis odontoid screw sighting device comprises a hollow guide tube and is characterized in that at least two telescopic connection rods are installed on the hollow guide tube, one ends of the telescopic connection rods are provided with sleeves, the hollow tube is inserted in the sleeves, and the other ends of the telescopic connection rods are connected onto a fine control panel which is connected with a supporting rod through a spherical joint. The axis odontoid screw sighting device is simple in structure and convenient to use, and can be used for guiding accurate positioning of kirschner wires during the axis odontoid fracture treatment. Therefore, operation quality is improved, operation errors are reduced, and pain of patients is alleviated.