Most sacral fractures have generally been treated with a nonoperative method. However, the authors of this study treated, with an operative method, a transverse sacral fracture that was displaced forward into the pelvic cavity and the patient also had extensive neurologic injury and instability. Fracture site stabilization and decompression proved to be successful management and the patient experienced a remarkably good outcome. In selected cases, surgical treatment is a good option for the management of transverse sacral fracture.