Objective: To investigate clinicopathologic features, diagnosis, differential diagnosis of sacral neurogenic tumors. Methods: Twenty one cases of sacral neurogenic tumors were collected. Microscopic examination and immunohistochemistry were performed for studying the clinical feature, radiologic appearance, pathologic characteristic, immunophenotyping, differential diagnosis and postoperative prognosis. Results: There were 15 females and 6 males, whose mean age was 44.9 years old. The majority of patients complained of pain in sacrococcygeal region. Radiographically, there was an endosacral or endosacral and presacral mass. Seventeen cases were schwannoma, including 8 cases of conventional schwannoma and 9 cases of cellular schwannoma. Three cases were neurofibroma. One case was ganglioneuroma. The destruction of bone were found in the cases of endosacral mass. Immunohistochemically, tumor cells of schwannoma were diffuse and strong positive for S-100 protein, negative for NF. Neurofibroma and ganglioneuroma cells were positive for NF, tumor recurrence of 4 cases occurred several years after initial surgical resection. The mean interval to recurrence was 6.5 years. Conventional schwannoma and neurofibroma each have 1 case for recurrent. Conclusion: Sacral neurogenic tumor is a rare tumor. Most of them are benign. There are many different pathologic features and growth pattern in pathological types and subtypes. So pathological diagnosis of the tumor should be noted for clinic follow-up and treatment.