Objective　To investigate the advantage and the feasibility of transiliac approach in the sacroiliac joint surgery.　Methods　From 2013 to 2015, totally 5 cases of sacroiliac joint infection (3 cases of sacroiliac joint tuberculosis, 2 cases of sacral infection related sacroiliac joint ) were treated by transiliac approach. The fenestration position was determined through the projection data of sacroiliac joint on the outer table of ilium by CT scanning and the location of the lesion. Then infection debridement was performed. The effect of anti-infective therapy and the influence of transiliac approach in sacroiliac joint function were followed up.　Results　All 5 patients had a follow-up of more than 12 months. The infection was eliminated in all patients who had returned to normal life and work. The X-ray and CT of pelvis showed no dislocation and unstable signs in the sacroiliac joint.　Conclusion　The transiliac approach can expose completely, avoid injury of joint ligaments and anterior vascular, nerve and other important structures. It also can reduce the effect on joint stability and have a low risk of operation. Compared with the classic anterior and posterior approach, the transiliac approach has obvious advantages and can be used as a new choice for the operation of sacroiliac joint.