The invention relates to a medical instrument, in particular to a double-ring type pivot cone odontoid sighting device for guiding hollow screw locating in pivot cone odontoid fracture treatment. The double-ring type pivot cone odontoid sighting device comprises a hollow guiding pipe and a sighting device connected to the hollow guiding pipe. The sighting device comprises an inner sleeve ring and an outer sleeve ring which are arranged concentrically. The inner sleeve ring, the outer sleeve ring and the hollow guiding pipe are connected through cross rotating shafts. The rotating shafts are formed by inner sleeve pipes and outer sleeve pipes in a sleeved mode, and the inner sleeve pipes and the outer sleeve pipes can rotate relatively and are arranged coaxially. The sighting device is simple in structure, convenient to use and accurate and quick in locating, the device can be used for guiding a Kirschner wire to be located accurately in pivot cone odontoid fracture treatment, accordingly, operation quality is improved, operation errors are reduced, and the pain of a patient is lowered.