Sacralization of the fifth lumbar vertebra, also known as Lumbosacral transitional vertebra (LSTV) (Jancuska et al, 2015), is a common congenital pathology that may affect up to 30% of the population (Alonzo et al, 2018). This condition is characterized by the enlargement, psuedo-articulation or fusion of one or both transverse processes of the fifth lumbar vertebrae to the sacrum. FSD 19- 232 arrived at the University of Montana Forensic Anthropology laboratory and was assigned by Dr. Kirsten Green Mink to Samantha Ramey and Samantha Hofland for forensic anthropological analysis. This case present unilateral stage 2 sacralization of the fifth lumbar vertebra to the sacral alae on the individual’s right side. Lumbosacral transitional vertebra is a common anatomical variation, but it can lead to other pathological conditions including spinal disc herniation, cervical ribs and Bertolotti’s syndrome (Shiksha, 2015). Based on the level of sacralization found on FSD 19-232, it is possible that this individual suffered from Bertolotti’s syndrome