Stress fracture of the pelvis represents one rare differential diagnosis among the manifold causes of low back pain in female athletes. We report a case of fatigue stress fracture of the pelvis in a 24-year-old female athlete as an unusual differential diagnosis of low back pain that should be taken into consideration. According to the literature the incidence of low back pain in athletes ranges from 1% to 30% and is influenced by sport type, gender, training intensity, training frequency and technique. In some cases, no specific pain generator is found, which makes diagnosis and treatment difficult. The frequency of the injury and the treatment options are discussed, based on published studies.