Dropped head syndrome (DHS) typically presents as chin-on-chest due to dysfunction of the cervical extensor muscles [1,2]. The main clinical finding is forward gaze disorder as the symptoms progress, and it affects various activities of daily living such as housework and walking. It was first reported in 1817 as a postural abnormality in Parkinson's disease [3], and since then it has also been reported to develop in comorbidity with various other diseases such as neurogenic, myogenic, and vertebral, as well as with malignant tumors [[4], [5], [6]]. In recent years, the number of isolated neck extensor myopathy (INEM) cases [6] without underlying diseases has been increasing due to the aging of our society [4]. The chief complaint of DHS is the difficulty of maintaining a forward gaze due to the chin-on-chest deformity. Unlike cervical kyphosis, the cervical deformity in DHS is caused by cervical extensor muscular weakness without obvious osteoarticular deformity, and it can be temporarily corrected [4,7]. Therefore, in mildly symptomatic cases, cervical X-ray findings could not reveal the dropped head condition, often making the initial diagnosis difficult. For this reason, even if the difficulty in head elevation is clinically recognized, it is hard to evaluate the DHS pathogenesis objectively. Previously, it has been mentioned that the pathogenesis of DHS existed at the cervico-thoracic extensor muscles [8,9] and that evaluation of the imaging findings by magnetic resonance imaging (MRI) at cervical extensor muscles would be valuable. However, most of the MRI evaluations of DHS were performed as a screening tool for neurological deficits including cervical spondylotic myelopathy or radiculopathy [4]. Although recent MRI studies mentioned the abnormality of cervical extensor muscles [10,11], the characteristics of MRI focusing comprehensively on cervical soft tissue and hard tissue conditions (including endplates) have been unclear, and detailed investigations have been awaited. The purpose of the present study was to clarify the MRI findings in regard to DHS within 6 months after onset.