Objective: To study the effects of three-step manipulation combined with traction on the severity of symptoms and neurological function in children with atlantoaxial suluxation tic syndrome. Methods: From April 2022 to February 2024, 80 children with atlantoaxial suluxation tic syndrome in our hospital were randomly assigned, with 40 patients in the conventional group receiving traction treatment and 40 patients in the study group receiving combined three-step and three-step manipulation treatment. The clinical efficacy, reduction effect, symptom severity and neurological function of the two groups were compared. Results: The total effective rate of the study group was higher than that of the conventional group (P < 0.05). After treatment, the difference in the distance between the lateral mass and the axial process and the YGTSS score of the study group were lower than those of the conventional group (P < 0.05). After treatment, the scores of sensory and motor nerve function in the study group were higher than those in the conventional group (P < 0.05). Conclusion: For children with atlantoaxial suluxation tic syndrome, three-step manipulation combined with traction can effectively reduce the severity of symptoms and promote the recovery of neurological function.