Researchers conducted retrospective research. Regarding wound healing complications, hardware prominence, and failure, they sought to discuss the modified iliac screw (mILS) technique and compare it to other spinopelvic fixation techniques. Between January 2014 and June 2019, a retrospective analysis of adult patients having lumbopelvic fixation (LPF) was conducted. Patients were divided into 1 of 3 groups based on their pelvic fixation technique: S2 alar-iliac (S2AI) screw, traditional iliac screw (tILS), or minimal iliac screw (mILS). The minimum distance between the screw head and the skin was the primary outcome parameter. Secondary outcome measures were instrumentation loosening/failure, neighboring level fractures, pseudoarthrosis, and medial or lateral iliac screw perforation. The following 3 groups of 190 patients receiving LPF were formed: the mILS group (n=113), the tILS group (n=40), and the S2AI group (n=37). The mILS group had a 31.3 mm mean minimum distance from the screw head to the skin compared to 23.7 mm in the tILS group (P<0.00199). No statistically significant differences were discovered when the 3 groups were compared in terms of complications. The mILS group had the lowest percentage of instrumentation failure and no incidents of unusual instrumentation. The iliac screw fixation benefits of mILS outweigh the offset connectors and screw prominence issues of tILS.