Occult sacral bifida, or occult sacral spondylolisthesis, is a condition in which the majority of people do not show clinical symptoms and do not require treatment, while those with clinical symptoms may be treated with functional exercises and, if necessary, surgery. Occult sacral bifida is a congenital developmental defect in which there is a sacral spinal canal defect but no bulging of the vertebral contents. For the majority of patients, the cryptic spina bifida gap is small and does not show relevant clinical symptoms, so no treatment is needed. Some patients may experience minor symptoms such as lumbosacral pain when standing or sitting for a long time, and may perform functional exercises for the lumbar and back muscles under the guidance of a doctor, such as horizontal leg raising and superman stretching. For those with large fissures and related neurological symptoms, surgery (e.g. cone fusion) should be performed in a timely manner. Occult sacral spondylolisthesis is often found unintentionally during local radiological examinations, and its treatment requires a specialized doctor’s diagnosis and assessment before choosing a specific treatment method.