Disclosed is a multi-axial occipito-cervical connection system that enables an occipital rod to be coupled to a cervical rod in a manner that permits multi-axial, relative movement between the two rods about a predetermined location, such as the heads of the rods. The system includes a locking mechanism that can be actuated to lock the relative positions of the rods. The rods can provide an interconnection between one or more attachments on the skull (such as an occipital attachment) and one or more attachments to the spine (such as spine screws).