Objective: To explore the application effect of 3D digital guide plate guided sacroiliac screw internal fixation in the treatment of pelvic posterior ring injury, in order to guide the selection of treatment plans for pelvic posterior ring fractures. Methods This study was a retrospective Case–control study. Forty five patients with posterior pelvic ring injury who were admitted to the orthopaedic trauma ward center of our hospital from January 2020 to February 2023 were collected as the study subjects. All the enrolled patients chose the surgical treatment scheme, and were grouped according to the different surgical schemes, namely, the patients in the 3D guide group, including 21 patients, and the patients in the conventional group, including 24 patients. Collect general information, surgical related information, follow-up data, etc. of two groups of patients, and use the pelvic Majeed function score and pelvic Matta function score for functional evaluation. Results There was no statistically significant difference between the two groups in terms of gender, age, cause of injury, type of Tile fracture, combined injury, and time from injury to surgery (P>0.05). The screw insertion time of the 3D guide plate group was significantly lower than that of the conventional group (P<0.05), the X-ray fluoroscopy time was significantly shorter than that of the conventional group (P<0.05), the number of needle adjustments was significantly lower than that of the conventional group (P<0.05), the Gras standard rating of screw position was significantly better than that of the conventional group (P<0.05), the healing time of bone fractures in the 3D guide plate group was significantly lower than that of the conventional group (P<0.05), and the quality of fracture reduction was better than that of the conventional group (P<0.05), The pelvic Majeed function score and pelvic Matta function score were significantly better than the conventional group (P<0.05). Conclusion 3D navigation template assisted sacroiliac screws can achieve good treatment results for pelvic posterior ring fractures.