Introduction:The sacral bone anomalies have an important effect on urinary and gastrointestinal tract and sacral ratio was defined as an indicator for estimating the anorectal abnormalities in children. This study was carried out for determining the association between sacral ratio and Urinary Tract Infections (UTI) among children.Material and Methods:In a cross sectional study, 100 children under 15 years with proven febrile UTI were referred to a referral children center considering the presence and grading of VUR according to VCUG enrolled in this study.Sacral ratio was measured for all cases and the data were compared by student T test, Chi 2 and Mann Whitney tests. SPSS 16.0 software was used for data analysis. P values less than 0.05 were considered significant.Results:41 boys and 59 girls with mean age 4.8 years were enrolled in this study. The average range of sacral ratio was 0.82. There was no staistical difference between two different genders and ages (p> 0.05).The values of SR in patients with VUR were lower than patients without VUR(P˂0.05) but there was no statistically significant difference between both bilateral and unilateral VUR and SR (p> 0.05).Conclusion:The risk of sacral bone abnormality in patients with VUR is more than patients without VUR. Therefore, in patients with UTI and low SR simultaneously, tighter evaluation for VUR and treatment should be considered.