Aim: To investigate the anatomical relationships of the structures and the topographic anatomy or the sacrospinous ligament and validate Current anatomic knowledge of this area. Materials: Nine embalmed half female cadaver pelvises were dissected to reveal the anatomy of the sacrospinous ligament. Results: The average length of the sacrospinous ligament was measured to be 43.04 +/- 6.58 mm. The inferior gluteal complex emerges from the infrapiriform foramen at a distance of 17.02 +/- 3.08 mm from the ischial spine and courses to inferior laterally with a slight curve. During this course, it passes close to the upper-lateral half of the sacrospinous ligament. The pudendal complex passes above the spine in six of the nine cases (66.6%) and lies maximum of 5.5 mm medial to the spine. Oil average the sciatic nerve is measured to he 25.14 +/- 3.94 mm lateral to the ischial spine. Conclusion: Placing the suture inferomedially and close to sacrum, the risk of complication will be minimal. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.