Presacral venous hemorrhage is a severe complication in low rectal surgery. This complication was encountered in 5 of 165 patients (3 percent) who underwent a presacral dissection for rectal mobilization. Conventional hemostatic measures often are ineffective to arrest this hemorrhage, and a number of alternative hemostatic techniques have been proposed. We report the successful tamponade of presacral hemorrhage with absorbable hemostatic sponges fixed to the sacrum with endoscopic helical tackers.