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Anterior sacral meningocele develops as a result of a defect characterized by focal erosion or hypogenesis of segments of the sacrum with herniation of the meningeal sac through the defect into the pelvis. It accounts for about 5% of  retrorectal masses, it is usually diagnosed in the second or third decades and are more prevalent in women.\cite{6828997} Presentation in elderly patients are less common, however it can occur as in the case described.  > They may be asymptomatic or present as nonspecific symptoms such as long-term constipation, urinary dysfunction, lower back pain, or perineal hypoalgesia. These symptoms may be due to direct compression of the herniated meningeal sac, spinal cord tethering, or sacral nerve root compression. As a result of this nonspecific symptoms, the diagnosis can be difficult and occasionally it can be confused with other entities such as ....  > ASM is either asymptomatic or  manifested by nonspecific symptoms as a result of pressure