Background: Complications of sacral fractures include hemorrhage, shock and neurological complications, sensory, motor. Objective: To evaluate the clinical and radiographical results of surgical treatment of unstable sacral fractures. Patients and Methods: This study was carried out as an interventional prospective study on 24 patients with unstable sacral fracture. Clinical evaluation was assessed, and Radiological assessment was done. Results: 17 patients underwent iliosacral screw, 4 spino pelvic, 2 patients underwent plate, and one plate with spinopelvic. Satisfactory outcome group significantly younger in age and shorter in operation days. In this study 7 cases of infection 6 superficial 1 deep. In this study, 1 pt had deep venous thrombosis, 3 chest infection. There were 2 cases with postoperative neurological deficits improved within 4 months and one case didn't improve during follow up. Post-operatively all patients were clinically assessed according to Majeed score. Excellent cases were 10 (41.7%), good results were 12(50%) and fair were 2 (8.3%). Conclusion: Patients were found to have a good outcome; therefore, surgical treatment is effective in unstable sacral fractures. Iliosacral screw fixation is indicated in minimally displaced fractures, usually performed percutaneously, consequently, blood loss is minimal. Sacral fractures are rare and detection of these potentially complicating fractures is very important.