Objective Study on the safety and therapeutic effect of percutaneous sacroiliac screw internal fixation in the treatment of pelvic posterior ring injury with transition vertebral in patients by 3D navigation. Methods A total of 21 patients with pelvic posterior ring injury with transition vertebral in the department of orthopedics of Wuhan general hospital from October 2015 to June 2018, including 12 males and 9 females with an average age of 25 to 63 years ( average 45.8 years ). Results A total of 22 sacroiliac screws and 25 retrograde anterior column screws were inserted, and each screw was placed in 20 ~ 38 ( average 29.12 ) min. 21 patients were followed up for 6 to 24 months,?averaging 11.74 months.The incision was not infected. After the operation, the X-ray and CT were fixed, and the hollow screws were not broken, loose and Prolapse.The quality of postoperative fracture reduction was evaluated according to Matta score standard: 14 cases were excellent, 5 cases were good, 2 case was fair, and the good rate was 90.48 %.During the last follow-up, the pelvic function was evaluated according to Majeed score criteria: 13 cases were excellent, 5 cases were good, 3 cases were poor, and the good rate was 85.71%.?2 of which were reexamined after operation, manifested as decreased limb activity; Another case was reexamined after operation, due to the femoral fracture, long-term lying in bed, showing limited activity. Conclusion Percutaneous sacroiliac screw internal fixation in the treatment of pelvic posterior ring injury with transition vertebral in patients by 3D navigation has the advantages of small trauma, short operation time and less blood loss during operation, and has certain clinical value.