Objective To study CT findings of sacral tuberculosis.Methods CT findings of sacral tuberculosis confirmed pathologically in 13 cases were analysed combined with literature review.Results The S 1～2 tuberculosis was most common.The types of sacrum destruction were osteolytic and bone destruction along the sacral foramen.The cold abscess were distributed at the presacral,unilateral iliac fossa and/or the gluteal region.Three patients(23.1%) were associated with sacroiliac joint tuberculosis(right 2,left 1).Conclusion In the patients with sacral tuberculosis the patterns of sacrum destruction,region of cold abscess and its relationship with the neighboring structures can be well showed by CT,and it can help surgeons to choose the appropriate surgical approach.