A rare lumbosacral fracture-dislocation occurred in a 22-year-old woman. In a review of the literature describing 17 additional cases, the injury was classified as rare and usually caused by severe trauma. The mechanism of injury is hyperflexion and rotation. In general, attention is drawn to the association of fractured transverse processes as an important clue to the diagnosis. Neural injury is frequent, as are fractures of the lumbosacral facet joints and sacral promontory. Attempts at closed reduction are futile, and the treatment of choice is open reduction and internal fixation with lumbosacral fusion.