Introduction and Hypothesis <p>This study is aimed at assessing how sacropelvic parameters influence the spatial proximity between the sacral promontory and the aorta–common iliac artery bifurcation, which is of particular relevance in gynecological surgeries involving the presacral region.</p> Methods <p>Abdominal computed tomography (CT) scans of 223 female patients, obtained for various unrelated clinical indications, were retrospectively evaluated. The distance between the aorta–common iliac artery bifurcation and the sacral promontory (aBPD), as well as sacropelvic parameters, were measured on these CT images. The relationship between aBPD and both demographic variables and sacropelvic parameters was analyzed.</p> Results <p>The average distance (aBPD) was measured as 40.81 mm, with the bifurcation most frequently located at the L4 vertebral body level. Statistical analyses revealed that the aBPD had a negative correlation with age (<i>p</i> &lt; 0.001) and hypertension (<i>p</i> = 0.026), while showing a positive correlation with BMI (<i>p</i> = 0.008), diagonal conjugate (DC) (<i>p</i> = 0.029), and pelvic thickness (PTH)&#xa0;(<i>p</i> = 0.031).</p> Conclusions <p>A shorter aBPD was identified in patients with hypertension, low BMI, shorter PTH, shorter DC, and advanced age. These findings underscore the importance of considering individual anatomical variations during surgical risk assessment. Recognizing such factors may help to reduce the risk of vascular injury and enhance the safety and effectiveness of sacropexy procedures.</p>