目的　探讨原发骶前肿瘤的诊断和手术治疗方法。方法　分析 1983～ 1999年治疗的 2 3例原发骶前肿瘤病人的临床资料 ,结合文献进行讨论。结果　 2 3例中先天性肿瘤为最常见类型。肛门指诊结合B超和CT检查对于术前评估非常重要。手术路径以经骶尾入路和经会阴入路最为常见。结论　如无手术禁忌证 ,所有原发骶前肿瘤均应予手术切除。应根据肿瘤的具体情况选择恰当的手术路径 ,术中应避免神经血管损伤 ,并尽可能完整切除肿瘤 Objective To investigate the diagnosis and surgical treatment of primary presacral tumors. Methods The clinical data of 23 patients with primary presacral tumor treated from 1983 to 1999 were analyzed and the literature was discussed. Results Congenital tumors were the most common type in 23 patients. Anal digitization combined with ultrasonography and CT examination is very important for preoperative evaluation. The surgical route is most common through the appendix approach and transperineal approach. Conclusions All primary presacral tumors should be surgically removed without surgical contraindications. The appropriate surgical route should be selected according to the specific conditions of the tumor. Neurovascular injury should be avoided during the operation and the tumor should be resected as completely as possible.