The sacral hiatus is a gap on the dorsal surface of the sacrum formed by the non-fusion of the lamina of the fourth and
fifth sacral vertebrae. A multitude of anatomical alternations of hiatus have been reported involving metric and non-metric
parameters. These have been identified during radiological investigations, surgical procedures or discovered in anatomical
and anthropological research studies. For successful outcomes in the clinical setting, it is vital that awareness of identified
and newly discovered anatomical variations is achieved through review of literature. Objective of this article is to provide
a systematic review of the reported anatomical variations of sacral hiatus with its clinical significance.