Abstract: Objective: To compare the diagnosis accuracy of sacral fracture between DR and MSCT and evaluate their guiding value to clinic treatment.Methods: Datum of DR and MSCT were analyzed retrospectively in 50 patients with sacral fracture.DR included the posteroanterior and lateral film.MSCT included valume rendering(VR)multi-plane recombination(MPR)and maximum intensity projection(MIP).Then we compared the diagnosis rating and classification between DR and MSCT,compared with operation results partly.Results: DR made a definite diagnosis of 26 cases(52%),missed diagnosis of 20 cases(40%)and suspected diagnosis of 4 cases(8%).MSCT made a definite diagnosis of 49 cases(98%),suspected diagnosis 1 cases(2%).The cases of definite diagnosis were classified with Denis method.19 cases(73.08%)are classified correctly by DR.49(100%) by MSCT.Thus it can be seen that there is noticeable statistic meaning in diagnosis rating and classification between DR and MSCT(P<0.01).33 cases with sacral fracture received conservative treatment.17 cases received operation.Operation observation and MSCT diagnosis is accordant.Conclusion: There is significant difference between DR and MSCT in diagnosis and classification of sacral fracture.DR can be early-stage screening examination,while MSCT can be routine examination and provide more valuable information for clinical diagnosis and treatment.