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Spina bifida is a congenital anomaly due to improper closure of embryonic neural tube leading to split or bifid spinal column. Spina bifida of sacrum may result in back pain, failure of epidural anaesthesia and defective trans-pedicular as well as lateral mass screw placement in sacrum. The authors chanced upon an adult female sacrum presenting with total spina bifida and sacralization of coccyx during routine osteology classes of a medical college of Odisha. The present case may be of considerable interest for anatomists, orthopaedicians, radiologists and anaesthesiologists.