OBJECTIVE: To evaluate the safety of iliosacral screw fixation in pelvic injuries. METHODS: A retrospective study based on computer tomography evaluation of screw topography and its relationship with the so called pelvic safe corridor. RESULTS: We evaluated the topography of 60 screws inserted in 46 patients sustaining pelvic injuries which were operated in the INTO from 2006 to 2010. In 21.7% of cases the screw was located outside the safe corridor. 77% of these misplaced screws were associated with an unsatisfactory reduction of the pelvic injury. CONCLUSIONS: In our study, a significant rate of misplaced screws in relationship with the safe corridor has been pointed out and in most of these cases an insufficient reduction of the pelvis was also identified. We conclude that iliosacral fixation is a safe adjuvant method for pelvic fixation since in our series even with a relative high incidence of misplacements, no neurovascular injuries have been recorded in association with this technique.