Introduction Identification of sex is fundamental to identify unknown individuals. In situations where the body is fragmented or mutilated, sex can be estimated through examination of the sexually dimorphic characteristics of skeletal parts. The pelvic bones, particularly the sacrum and coccyx have been investigated and found characterized for sexual dimorphism. They were considered as an accurate tool to determine adult sex in some populations. Aim: to get an accurate method for adult sex determination among Egyptian population. Objectives: to identify sacral and coccygeal osteometric differences between sexes using Multi Detector Computed Tomography (MDCT) images in a sample of Egyptians. Furthermore, to set up a formula for sex identification from sacrococcygeal measurements in a sample of Egyptians. Subjects and methods: A cross-sectional comparative study was conducted on 220 Egyptian subjects (110 males and 110 females) who underwent pelviabdominal CT at Diagnostic Radiology Department, Suez Canal University Teaching Hospitals. Ten measurements of the sacrum and coccyx for each participant were obtained and assessed for sexual dimorphism. Results: All measurements were significantly larger for males except for the maximum breadth of alae of the sacrum (MBA) and the sacrococcygeal curve angle (SCCA). Antero-posterior diameter of the first sacral vertebra (APD) followed by anterior sacrococcygeal length (ASCL) provided accuracy for sex discrimination of 74.55% and 72.73% respectively using receiver operating characteristics (ROC) analysis. The Binary logistic regression (BLR) model correctly classified 87.3% of males and 85.5% of females, with an overall classification accuracy of 86.4%. The regression formula had a sensitivity of 83.6%, specificity of 82.7% and accuracy of 83.6%. Conclusion: sacrococcygeal parameters showed significant differences between males and females and could be useful for sex identification in forensic cases.