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# Introduction  Anterior sacral meningocele is a relative rare congenital anomaly of the pre-sacral region, it is defined as a meningeal cyst produced by agenesis of a portion of the anterior sacrum which develops into a herniation of meninges through the defect.\cite{6470791} It is been reported that erosion of the anterior wall of the sacrum and even sacral fractures could develop into this kind of lesions. lesions.\cite{23829288}  In approximately 50% of cases, associated malformations are found, which could include spina bifida, spinal dysraphism, imperforate anus, etc.\cite{11353107} Sometimes is associated with syndromes such as Currarino and Marfan syndromes.\cite{24745342} The clinical and radiological features of this condition are characteristic, although neurological complications are considered uncommon, meningitis, sepsis, obstetric problems, and bowel and bladder difficulties can develop.\cite{11956924}\cite{11147856} Surgical treatment is the standard for symptomatic or growing masses with compression of adjacent structures. The dural defect can be repaired with a variety of anterior or posterior neurosurgical approaches.\cite{16793455} We present a case of a 82-year-old female patient with an anterior sacral meningocele that was successfully treated via an open posterior approach. We discuss the treatment options and a review of the literature.