The surgical treatment for sacral tumors in China began in the late 1960s. Through continuous exploration, great progress had been made in surgical resection of sacral tumors, and the rescue operation had gradually become a routine surgery. With his clinical work for more than 40 years and his own experience of diagnosis and treatment of more than 600 patients with sacral tumors, the author summarized how to reduce the incidence of complications and control the bleeding. Postoperative hemoglobin was around 10 g/dl and the operation time was reduced to 2-3 hours. The author also demonstrated the feasibility and rationality of using the sub-total sacrectomy instead of the total sacrectomy, and the stability of the lumbosacral joint maintained by a new anatomical structure composed of the residual bone shell, joints, ligaments and scar tissue without internal fixation. The author introduced the methods of diagnosis and differential diagnosis according to the characteristics of different sacral tumors. 3 kinds of sacral tumor resection were proposed in accordance with the location of the tumor. Normal function of the lower limbs and defecation could be archived with retained S1, S2, S3 nerve and bilateral or unilateral S4 nerve. In order to reduce the recurrence rate, the author put forward the new ideas of complete resection for sacral malignant tumors.