This chapter presents a glimpse on neglected trauma in spine and pelvis. Early correct management of a severe injury of the pelvis is often easy but, late correction is more difficult, less successful, and associated with a higher incidence of complications than management of acute pelvic fractures. Operative correction of pelvic deformity is difficult and should be undertaken only by surgeons experienced in pelvic surgery. The most common symptoms of neglected pelvis fracture are sacroiliac pain secondary to instability of the posterior sacroiliac complex. The only absolute indication for surgery is pain unrelieved by nonoperative treatment. Sacral nonunions are approached properly and fixed with screws from sacrum to iliac. Nonunion of iliac wing is rare but is usually easy to correct. Neglected pelvis fracture especially the vertical fracture may present with limb length discrepancy (LLD). To correct (LLD), there are two options i.e. modified Salter’s osteotomy with lengthening of the pelvis and second option is lengthening femur or tibia. The third option is a simple shoe raise may compensate for shortening.