Osteoid osteoma is a benign bone tumor that occurs most frequently in long bones such as femur and tibia. The spine is a rare localization of osteoid osteoma and the coccyx even more exceptional. We report a case of osteoid osteoma of the coccyx in a young man with sacrococcygeal pain which was relieved by salicylates. Computed tomography, bone scan and magnetic resonance imaging of the region demonstrated a typical osteoid osteoma lesion. After the operative curettage of the tumor, the pain and clinical symptoms dramatically stopped. Since coccygeal osteoid osteoma is a very rare condition, the disease may be confused with other common lesions such as traumatic lesions. Therefore, in chronic pains, further investigation by CT scan of the coccyx area is essential to rule out osteoid osteoma.