A52-year-oldwomanunderwenthealthcheckup,whichrevealedamultilocularcystictumor(7cm) inthepresacralpelviccavity.Themasswasdiagnosedasasacrococcygealcystictumorwithmalignant potential,andweperformedsurgicalresectionviaanabdomino-sacralapproach,followedbylaparoscopic surgery.Histopathologicalexaminationoftheresectedspecimenrevealedamaturesacrococcygealteratoma.Thepatient'spostoperativecoursewasuneventful,andnorecurrencewasobservedat1yearand5 monthsfollow-up.Althoughrareinadults,maturesacrococcygealteratomasareknowntoshowmalignant changes;therefore, early surgical resection is recommended. A combined sacral and laparoscopic approachwasusefulforoptimalvisualizationofthesurgicalfieldandproceduralsafetyinourpatient.