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Sacral orientation and external morphology in modern humans are distinct from those in other primates and compatible with the demands of habitual bipedal locomotion. Among nonhuman primates, however, how sacral anatomy relates to positional behaviors is less clear. As an alternative to evaluation of the sacrum's external morphology, this study assesses if the sacrum's internal morphology (i.e., trabecular bone) differs among extant primates. The primary hypothesis tested is that trabecular bone parameters with established functional relevance will differ in the first sacral vertebra (S1) among extant primates that vary in positional behaviors. Results for analyses of individual variables demonstrate that bone volume fraction, degree of anisotropy, trabecular number, and size\u2010corrected trabecular thickness differ among primates grouped by positional behaviors to some extent, but not always in ways consistent with functional expectations. When examined as a suite, these trabecular parameters distinguish obligate bipeds from other positional behavior groups; and, the latter three trabecular bone variables further distinguish knuckle\u2010walking terrestrial quadrupeds from manual suspensor\u2010brachiators, vertical clingers and leapers, and arboreal quadrupeds, as well as between arboreal and terrestrial quadrupeds. As in other regions of the skeleton in modern humans, trabecular bone in S1 exhibits distinctively low bone volume fraction. Results from this study of extant primate S1 trabecular bone structural variation provide a functional context for interpretations concerning the positional behaviors of extinct primates based on internal sacral morphology. 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