The pelvis, both in the female and male forms, proves to be one of the most complex anatomic and physiologic regions within the human body. Nowhere else in the body can one fnd the multitude of muscles, tendons, nerves, ligaments, blood vessels, organs and physiological functions tightly knit into such a compact structure (Fig. 1.1). The pelvis is responsible for biped ambulation and support of the spinal column, sexuality, reproduction, storage and elimination of urinary and fecal waste, and indeed represents the human body’s foundation for both form and function. A thorough and proper understanding of all of these structures and functions and how they integrate into one seamless anatomic box is of paramount importance for the surgeon operating within the pelvis. In order to be successful, the surgeon who operates within the pelvis must be disciplined and prepared, as along with its complexity, comes a great deal of risk. Often times it is resourcefulness and creativity that allows successful surgical operations here, and this can only be made possible with an appropriate fund of knowledge. Perhaps one of the most fascinating aspects of the pelvis is its remarkable dynamic nature. From its embryological origins, through its fetal and adolescent development and into its adult maturation and fnally senescent changes in older age, it truly embodies the point that the only thing that is constant is change. In addition to its evolution along the broader span of one’s life span, it has only recently been truly recognized for its dynamic nature in daily activities.