Sacral fractures usually occur as a result of high-energy trauma. These fractures are often overlooked and detected late, which can lead to serious complications. The most common causes of sacral fractures include falls from heights, traffic accidents, and crush injuries. Various classification and evaluation systems have been developed for the diagnosis of sacral fractures, the determination of the treatment algorithm, and surgical indications. Among these, the Denis and AO spine classifications are widely accepted classifications. Surgical treatment of sacral fractures plays a critical role in improving the patient`s functional status and pain relief. Currently, the choice of surgical methods varies depending on the type of fracture, the patient`s general health status, and the evaluation of the neural tissues affected by the fracture. The goals of surgical intervention include achieving bone stability, neural decompression, and reduce pain. In sacral trauma cases accompanied by neural tissue injuries, surgical options are prioritized, and neurological recovery can be achieved with early diagnosis and appropriate treatment. However, the overall strength of evidence for the treatment of sacral fractures remains weak in the current literature. Treatment recommendations should be customized according to the patient`s clinical condition.