Sacral tumors are relatively rare, and experience related to resection of these tumors is therefore usually limited to a small number of patients. The purpose of this retrospective study was to review the surgical experience of the National Cancer Institute in sacral neoplasms over the last 10 years. Thirty-seven patients with different pathologic entities had been subjected to resection of the sacral bone for management of sacral tumors in the National Cancer Institute between January 1997 and December 2006. Twenty-three were males and forteen were females. The median age at diagnosis was (44ys). The mean duration between the onset of symptoms and diagnosis was 8 months. The most common clinical presentation was local pain and the most common pathological diagnosis was chordoma (13 cases). All of our patients underwent sacral resection using the combined sequential abdomino-sacral approach except two patients in whom the posterior approach only was feasible. No perioperative mortality was recorded. Patients in whom the most proximal sacral nerve roots preserved were S2 bilaterally experienced no sphincteric disturbances. None of the patients in this study developed spinopelvic instability. Aduvant radiotherapy was given in 13 patients, while adjuvant chemotherapy was given in 3 cases. The median time between operation and date of last followup was 42 months (range 11 to 96 months). Local recurrence developed in 7 patients, distant metastases developed in 5 patients while both occured in two patients. At last followup, 23 patients were still alive, of whom 20 have no evidence of disase. Despite the potential for complications, sacrectomy can be performed successfully, and is an important procedure in the treatment of primary sacral tumors.