Abstract
Sacral agenesis is a rare congenital anomaly with varying severity, from partial sacral hypoplasia to complete absence of the sacrum and coccyx. Often linked to maternal diabetes, it can cause significant neuromuscular and genitourinary complications. We present a 12-year-old female patient from a low-resource setting with lifelong lower limb weakness and urinary incontinence, born to a diabetic mother and diagnosed with sacral agenesis Type II. Financial constraints limited further management. This case highlights the challenges of delayed diagnosis and treatment, underscoring the need for improved healthcare access to ensure timely intervention for congenital disorders, particularly in underserved populations.