Pelvic fractures are relatively uncommon, and in workers’ compensation most pelvic fractures are the result of an acute, high-impact event such as a fall from a roof or an automobile collision. A person with osteoporosis may sustain a pelvic fracture from a lower-impact injury such as a minor fall. Further, major parts of the bladder, bowel, reproductive organs, nerves, and blood vessels pass through the pelvic ring, and traumatic pelvic fractures that result from a high-impact event often coincide with damaged organs, significant bleeding, and sensory and motor dysfunction. Following are the steps in the rating process: 1) assign the diagnosis and impairment class for the pelvis; 2) assign the functional history, physical examination, and clinical studies grade modifiers; and 3) apply the net adjustment formula. Because pelvic fractures are so uncommon, raters may be less familiar with the rating process for these types of injuries. The diagnosis-based methodology for rating pelvic fractures is consistent with the process used to rate other musculoskeletal impairments. Evaluators must base the rating on reliable data when the patient is at maximum medical impairment and must assess possible impairment from concomitant injuries.