© 2016, Springer-Verlag France. Introduction: Several important steps occur in order for the sacrum to develop properly. Embryological derailment can result in several different anatomical variants. Case report: Herein, we report, to our knowledge, the first case of a duplicated sacrum in the sagittal plane. Conclusions: Clinicians and radiologists should be aware of such a finding if found during imaging. We would hypothesize that such a variant occurred near the 29th day of development and probably arose from an error in the HOX gene. To our knowledge, this represents the first reported case.