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Sacrum is an extremely rare site for osteoid osteoma. We present a 25 year-old male, a computer operator who presented with chronic back pain of 4 years duration. He was initially investigated with routine x-rays and lab investigations and was treated for chronic back pain at another facility. Extensive work up at our clinic revealed a diagnosis of Osteoid Osteoma of Right 2nd Sacral vertebral arch Interlesional resection of the tumor was done and this was verified on histopathology. The patient had complete relief of pain following surgery. Repeat CT scan done at one year follow up. It showed complete removal of the Nidus. To the best of our knowledge there have not been many case reports in English Literature from the Indian subcontinent. There are many studies in which tumor of lumbar region is one of the causes of radiating pain in lower extremities but to the best of our knowledge this finding is unique and can also be an important cause of radicular pain.
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