Sacropelvic fixation is frequently used for the correction of complex pediatric spine deformities. S2-alar-iliac (S2AI) screws are a powerful method to obtain iliac fixation. Advantages include a medialized starting point that requires less soft tissue dissection, no need for connectors to the rod, and reduced screw head prominence. Though the technique for S2AI placement under free-hand and fluoroscopic techniques has been described, there is limited description of computed tomography (CT)-guided technique for the placement of S2AI screws in pediatric patients undergoing surgery for complex spinal deformity. This video presents our technique for placement of S2AI screws via CT-guided navigation.