Introduction Pelvic osteomyelitis is one of the worse but preventable complication of stage IV pressure sores. Most seen in bed bound patients affected by CNS injuries. Timely multi-disciplinary intervention with antibiotics and proper surgical procedures can reduce the morbidity and mortality for the patients.

Aim The primary aim of the study is to understand the local prevalence of pelvic osteomyelitis complicating pressure sore and to develop a treatment algorithm after doing a literature search.

Materials and Methods A retrospective study was conducted among the patients who have been diagnosed with pelvic osteomyelitis due pressure sore during a period of one year in a district general hospital. A literature search has been done and the selected articles were reviewed, and the findings were used to develop a treatment algorithm for patients.

Results During the study period 234 patients were diagnosed with osteomyelitis. Out of that 22 were pelvic osteomyelitis. Among that 16 (72.7%) were due to sacral pressure sores. 50% of them diagnosed with various neurological defect which impairs the mobility of the patients. Only 37.5% received combined medical and surgical treatment, rest of them managed with antibiotic therapy. 5 patients got readmitted due to reinfections and recurrent pressure sores. Interestingly all of them who got readmitted where those who received antibiotic therapy alone.

Conclusion To conclude, prevention is always better than cure. Patients coming to the hospital must be risk accessed and care must be given to prevent pressure sores. Early changes must be noted, and proper care must be given in the initial stages itself. Management of pelvic osteomyelitis requires a team of doctors. From the literatures its evident that recurrences, reinfections, and readmissions are low in those who have been treated with combined medical and surgical management.