A meningocele is a neural tube birth defect where there is a sac protruding from the spinal column and when repaired can lead to soft tissue defects. The main objective of meningocele defect closures for the reconstructive surgeon is to preserve neural tissue function and to prevent secondary infection. Closure in the sacral region can be quite a challenging task and takes planning depending on the defect size and shape. Previously latissimus dorsi and gluteus maximus musculocutaneous flaps have been described for lower sacral defects post meningocele repairs however these require extensive dissection. We describe the use of the inferior gluteal artery muscle flap for a sacral defect post meningocele repair. A twenty five year old female under the care of the neurosurgery team had a large anterior sacral meningocele removed and S2/S3 laminectomy. It was originally repaired and plugged with fat grafting however the patient later developed a pseudomeningocele and dural leak consequently leading to multiple repairs and procedures. Eventually the patient was left with a large sacral defect with an underlying dermoid cyst. A joint procedure was performed between the neurosurgery and plastic and reconstructive surgery team, where the dural leak was repaired and an inferior gluteal artery muscle flap was carefully designed and raised to fill the sacral defect with primarily closure of the overlying skin. Post-operatively the patient healed very well, progressed through her sitting protocol and was discharged back to normal function.