Chronic low back pain secondary to sacroiliac joint pathology is a clinical entity that is increasingly recognized and has controversial treatment options. Sacroiliac joint injection is a common diagnostic and therapeutic modality utilized in sacroiliac joint pathologies. It is regarded as a gold-standard diagnostic modality and offers a plausible alternative to surgical treatment with increasing evidence of its efficacy. Sacroiliac joint injections are typically performed under fluoroscopic guidance and the injections usually comprise a combination of local anesthetic and steroid. Despite its popularity and reported efficacy, the current available literature is unable to fully conclude the effectiveness of the modality and provide adequate comparison against surgical treatment. The underlying mechanism of action is also yet to be well elucidated. We hereby describe the technique of fluoroscopy-guided sacroiliac joint injections for both diagnostic and therapeutic purposes. The article gives an overview of essential requirements for the procedure, concepts, technical tips, and potential complications.