Background: Massive life threatening bleeding from presacral venous plexus in gynecological surgery, though uncommon can be fatal when conventional methods fail.
Case: In the present case, a 55-year-old woman undergoing radical hysterectomy for cancer cervix was saved using thumbtacks to control bleeding from presacral vessels when conventional methods were ineffective.
Conclusion: Use of thumbtacks in such patients is simple, cost effective and life saving.