The aim of this study is to formulate a protocol for reconstruction of sacral pressure sores by analyzing the data. A total of 50 patients with age ranging from 18 to 84 years were diagnosed with sacral pressure sore. Traumatic paraplegia, post traumatic quadriplegia, encephalitis, tumor compression causing paraplegia, fracture pelvis, fracture of neck of femur and head injury were the primary diagnosis. The pressure sores were managed by various reconstructive methods. Defects of <5cm and 5- 10cm are best managed by the following flaps – VY advancement, Skin rotation, Limberg flaps. Pressure sores of >10cm are best managed by bilateral skin rotation and transverse lumbosacral flaps. Effective control of infection by medical and surgical means prevents progression of pressure sores and promotes early wound healing. All bedridden patients need to be properly educated regarding prevention of pressure sores and routine self-examination for development of new pressure sores.