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Adana Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Seyhan, Adana, Türkiye Sacral agenesis is existence of one more sacral segment. Sacral agenesis may be alone or assosiated with orthopedic, urological, norological and anorectal system pathologies. Sacral agenesis is a vertebral anomaly which includes coccyx, lombar and sometimes low dorsal segments and classified in caudal regression syndrome family. Sacral or lumbosacral agenesis is a rare congenital defect in which cases are assosiated with spinal cord malformations, genito-urinary system and gastrointestinal system malformations. Diagnosis may easly done with X-Ray, computer tomograpy or manyetic resonance. In neurosurgery there are lots of reasons for low back pain. In this study we report a case of a sacral agenesis who presented with only back pain. Anahtar Kelimeler : Sacral agenesis, Back pain, Adult, Congenital anomaly