Pelvic insufficiency fractures (PIF) are a special category of pelvic fractures with normal stress or minor trauma acting on the weakened pelvis, whereas those that cause nonspecific lumbar and/or groin pain, and interfere with ambulation with subtle radiographic imaging changes. With the aggravation of the aging society, the incidence of PIF is increasing. PIF commonly results from osteoporosis, and may also occur due to radiation and chronic steroid usage. PIF is often misdiagnosed because of its insidious onset without special clinical symptoms. Pelvic X-ray is mostly used for screening and follow-up, whereas CT and MRI can confirm the diagnosis and is helpful to therapy. The conservative treatment of PIF includes analgesics, bed rest, physical therapy and orthoses. Patients who are unresponsive to this management and who have intractable pain are candidates for percutaneous iliosacral screw fixation or sacroplasty. We reviewed the literature on PIF in recent years, in order to provide reference for clinicians in the diagnosis and treatment of PIF.