Abstract: Objective To evaluate the effect of low abdominal aortic balloon occlusion on reducing blood loss during giant sacral tumor resection. Methods The clinical data of 17 cases of giant sacral tumor admitted from June 2012 to October 2014 in our department were retrospectively analyzed. All the patients underwent giant sacral tumor resection with low abdominal aortic balloon occlusion using a single posterior approach. The intraoperative blood loss and blood transfusion, postoperative blood transfusion and drainage, postoperative Frankel grading and Karnofsky score, postoperative hospital stay and complications were all recorded. Results The mean maximum diameter of tumor was （9.2±2.1） cm. The mean operative time was （230.5±100.0） min, intraoperative blood loss was （761.8±903.2） mL. There were 9 and 2 patients received intraoperative and postoperative blood transfusion, respectively. The mean postoperative hospitalization was （14.4±9.4） d, the mean postoperative drainage was （990.4±1 139.4） mL, the mean exultation time was （7.0±3.0） d. The postoperative Frankel grade was significantly improved compared with preoperative （Z=-2.828, P=0.005） and the Karnofsky score also increased significantly （81.2±8.6 vs. 71.2±7.8; t=-11.662, P<0.001）. There were 7 cases of complications, including 1 case of incision fat liquefaction, 2 cases of subcutaneous effusion, 2 cases of incision infection, 1 case of long-term indwelling urethral catheterization, 1 case of postoperative delirium, and all recovered after treatment. Following up for 6~41 months, 3 cases died （1 case of multiple myeloma and 2 cases of sacral metastasis of lung cancer） and 4 cases suffered local recurrence （2 cases of chordoma, 1 case of teratoma and 1 case of sacral metastasis of liver cancer）, and the recurrent patients were all under controlled after radiotherapy or chemotherapy. Conclusion The low level abdominal aortic balloon occlusion can effectively reduce blood loss during giant sacral tumor resection and it is worthy of clinical application.