Objective: Sacroiliac joint (SIJ) dysfunction is typically managed through nonsurgical approaches or surgical intervention, such as SIJ fusion. Many insurance providers use body mass index (BMI) as a criterion for surgical approval, with a common cutoff set at 35 kg/m². This practice often restricts obese patients to nonsurgical management options. However, there is limited evidence regarding the outcomes of nonsurgical management for SIJ pain in individuals with varying BMI categories. Design: Retrospective Review Setting: Academic medical institution Participants: Adult patients ? 21 years of age who received nonsurgical treatment for sacroiliac joint dysfunction between 2021 and 2023. Participants were classified using the National Institutes for Health body mass index (BMI). Patients with a BMI of 30 to 39 with no significant comorbidity are considered obese, patients with a BMI of 35 to 39 with a significant comorbidity or a BMI of 40 or greater are considered morbidly obese. Interventions: Non-surgical management (physical therapy, injection, radiofrequency ablation, bariatric surgery, pain management), SIJ fusion Main Outcome Measure(s): All subjects completed the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at baseline and 12 months. Results: Overall, mean VAS demonstrated negligible improvement at 12 months (1.8-point improvement; p=0.77). Over the 12-month follow-up period, BMI category did not impact mean improvement in VAS (ANOVA p=0.99). Mean ODI at 12 months demonstrated negligible improvement (9.3-point improvement; p=0.50). BMI category did impact mean improvement in ODI (ANOVA p=0.54). Conclusions: Our findings suggest the success of nonsurgical management of SIJ pain is limited and difficult to predict which is consistent with current literature as patients treated with continual nonsurgical management demonstrate no long-term improvement in pain or disability.