A sacral dural arteriovenous fistula (dAVF) is extremely rare, and the pathophysiological and clinical features have not been established. A 70-year-old man developed gradually progressive right-dominant bilateral sensory disorder of the lower limbs. His clinical course and electrophysiological findings were similar to those of multiple mononeuropathy. However, angiography showed a sacral dAVF at the right intervertebral foramen between the fifth lumbar and first sacral vertebrae. Endovascular embolization of the dAVF improved his clinical symptoms and electrophysiological findings. A sacral dAVF can mimic multiple mononeuropathy in terms of its clinical features and electrophysiological findings. A sacral dAVF is a treatable disease and should be considered as a differential diagnosis of lower extremity disorders.

骶骨硬脑膜动静脉瘘（dAVF）极为罕见，其病理生理和临床特征尚未确定。一名 70 岁男性逐渐出现进行性下肢右显性双侧感觉障碍。他的临床病程和电生理检查结果与多发性单神经病相似。然而，血管造影显示在第五腰椎和第一骶椎之间的右侧椎间孔处有骶骨 dAVF。dAVF 的血管内栓塞改善了他的临床症状和电生理检查结果。骶骨 dAVF 在其临床特征和电生理学表现方面可以模仿多发性单神经病。骶骨 dAVF 是一种可治疗的疾病，应被视为下肢疾病的鉴别诊断。