Objective To analyze the CT features of sacroiliac joint in renal osteodystrophy (ROD) patients, and to improve the understanding of it. Methods The clinical and imaging data of 25 patients (14 male, 11 female) with ROD were analyzed retrospectively. In the 25 cases, the age was from 29 to 69 years with median age of 49 years. CT features included: density, positions, boundary, joint clearance, bone and soft tissue around the lesions. Results All ROD patients were bilateral sacroiliac joints iliac bone involvement, accompanied by a variety of other ROD image performance, including osteoporosis(23 cases), Osteomalacia (21 cases), bone sclerosis(9 cases), brown tumor(10 cases), abnormal soft tissue calcification(15 cases), pathologic fracture(5 cases), ormal sacroiliac joint clearance(35 lesions), gap widened(15 cases), double-line sign(17 cases). Conclusion The involvement of the sacroiliac joint in renal osteopathy is bilateral bone destruction of the iliac side, with a variety of ROD image performance, double-line sign and joint gap widened were its characteristics, combined with the other imaging manifestations and clinical history can improve the diagnostic rate of sacroiliac joint lesions. CT has a certain value in its diagnosis.