Sacral insufficiency fractures (SIF) are pathologies seen especially in the elderly population due to factors such as osteoporosis, osteopenia, spinal instrumentation. SIF, which can occur with normal physiological loading, is a pain that starts from the sacrum and spreads to the hip and increases with palpation. Most cases cannot be diagnosed or are diagnosed very late. The probability of diagnosis with X-ray is low, and almost 100% diagnosis can be made with computerized tomography and magnetic resonance imaging. Most patients are treated with rest, supportive systems and analgesics. Sacroplasty is an effective solution in cases resistant to treatment. The thermal effect created by the PMMA and its preventive effect on microfractures reduce pain and increase the biomechanical strength of the sacrum.