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Investigate the incidence of sacral dysmorphism (SD) in patients with spinopelvic dissociation (SPD). Retrospective case series. Two academic level 1 trauma centers. One thousand eight hundred fifty adult patients with sacral and pelvic fractures (OTA/AO 61-A, B, C). Plain pelvic radiographs and CT scans. Incidence of SD in patients with SPD. Secondary radiographic evaluation of fracture classification and deformity on sagittal imaging. Eighty-two patients with SPD were identified, and 12.2% displayed features of SD, significantly l