Background:The increased biomechanical load and intricate regional anatomy make the spinopelvic region a particularly challenging junctional place to navigate. Cases involving severe deformities, high degree spondylolisthesis, or complex fractures, however, warrant extension of the construct. Pseudoarthrosis and fixation failures are still obstacles. In addition to being a biomechanically distinct zone, the spinipelvis is an architecturally intricate area that transfers axial weights to the lower appendicular skeleton via the pelvic girdle and the transitional lumbosacral junction. Sacropelvic fixation is necessary when sacral instrumentation is inadequate to accomplish solid arthrodesis across the lumbosacral junction; this commonly occurs in cases of long-segment fusions, high-grade spondylolisthesis, corrections of deformities, complex sacral/lumbosacral injuries, and neoplasms. Several recent methods of sacropelvic fixation are superior to their predecessors, particularly the percutaneous iliac and traditionally open methods, as well as the S2-alar-iliac screw (S2AI) fixation procedure. Aiming to increase precision and minimize problems, novel screw insertion technologies including navigation and robotics, along with modern screw designs, are being developed. This article provides context on evolution, biomechanics, and the various modalities of spinopelvic fixation, including its most current update.