Sacral tumors are a group of neoplasms heterogeneous in the histological type, malignancy, and growth pattern, but with common localization. Surgical treatment of these tumors is associated with the risk of major and minor complications, both during and after surgery. Usually, any surgery aimed at removing tumors in the sacrum or sacral region is associated with the need for reconstruction of bones and/or soft tissues to provide conditions for normal wound healing and the possibility of activating the patient. Aim — the study aim was to analyze complications associated with surgery for sacral tumors. Material and methods. The study is based on the experience of surgical treatment of 57 patients with the diagnosis of sacral tumor. The patients underwent 60 surgical interventions related to treatment of the underlying pathology and complications of surgical treatment. Major and minor complications developed in 37 (68%) operated patients. A total of 47 different complications were recorded. In 6 patients, complications in the early postoperative period required additional surgery. Conclusion. Surgical treatment of sacral tumors is associated with a high risk of complications. Despite the potential risk of major complications, sacrectomy for primary, or potentially aggressive, or malignant neurogenic tumors of the sacrum is necessary to improve local control and survival of patients.