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The cervical spine is highly susceptible to injury from blunt acceleration/deceleration trauma, most commonly manifesting as whiplash-associated disorder (WAD). Although WAD is often considered a self-limiting soft-tissue injury, certain anatomical variants may influence clinical presentation and management. One such variant is the ponticulus posticus (PP), a bony bridge on the posterior arch of the atlas that can encase the vertebral artery. This narrative review examines the prevalence, anatomy, and potential clinical associations of PP in patients with WAD. While large prospective studies directly linking missed PP to adverse whiplash outcomes are limited, multiple anatomical and imaging studies demonstrate associations between PP and vertebral artery compression or tethering. Current clinical decision rules (NEXUS and Canadian C-Spine Rule) are highly validated for detecting clinically important cervical fractures but were not designed to identify anatomical variants such as PP. Plain-film cervical radiographs can readily visualize PP and may therefore provide additional information in selected trauma patients.