There are very few reports on the surgical management of presacral masses (PSM) via a posterior sagittal (PS) approach. Between 1994 and 2000, we followed five girls who had been operated upon for PSMs via a PS approach. The mean age was 28.8 ± 16.6 months (6-48 months). The mean follow-up was 3 ± 1.6 years (1-5 years). Although two patients had yolk-sac tumors, all patients are still alive. We believe that this is a safe and satisfactory method for resection of PSMs.