Sacral plexus block is one of the most common neurological block techniques in lower extremity surgery in the clinic. Compared with the defects of traditional and computer tomography (CT)‑guided techniques, the ultrasound‑guided technique has been widely used in clinics in recent years due to its unique advantages of safety, real‑time, dynamic, and visualization, which promotes the development of sacral plexus block technology tremendously. This review aimed to summarize the different approaches, advantages, and disadvantages of ultrasound‑guided sacral plexus block techniques （the para‑sacral approach, the lateral approach, and the lumbosacral trunk block have appeared subsequently）, the maneuverability, advantages, and disadvantages of the diverse approaches should be considered comprehensively in clinical application, and to provide a reference for the selections of clinical anesthesia.