Widespread antibiotic therapy has markedly reduced the incidence of retropharyngeal abscess with that of the deep neck infection. But a retropharyngeal abscess was still considered as an important disease, because serious complication and tragic end could be encountered by the loss of a optimal chance of its diagnosis and treatment. In the mean time, retropharyngeal abscess most commonly developed in children but rare in adults. Even though it developed in adults, secondarily, its cause was tuberculous osteomyelitis of cervical vertebrae. We report a recent case of retropharyngeal abscess which developed in adult by a pyogenic osteomyelitis of the cervical vertebrae with a review of the literature.