The sacrum is a crucial bone that facilitates load transfer between the spine and pelvis. It contains sacral nerve roots, and sacral injuries can affect lower limb and urogenital functions. Sacral fractures, although rare, can be challenging to diagnose. They occur due to trauma in young individuals and osteoporosis-related factors in the elderly. Sacral fractures are observed in 30- 45% of pelvic injuries, and 25% of these cases may lead to neurological damage. Isolated sacral fractures are observed in only 5% of cases. Radiography is often insufficient for diagnosis, while CT is the most reliable method. Treatment varies depending on the stability of the fracture. Severe fractures may require surgery, whereas for stable fractures, pain management, vitamin D and calcium supplementation, and early mobilization are recommended. Additionally, innovative approaches such as physical and electromagnetic therapy and sacroplasty are applied for sacral stress fractures. Sacral fractures are complex injuries that require a multidisciplinary approach, and early diagnosis and appropriate treatment can help prevent serious complications.