A polyaxial bone anchoring device includes: an anchoring element having a shaft and a head a receiving part having a top end, a bottom end, and an accommodation space for accommodating the head, the accommodation space having a lower opening at the bottom end, a sleeve-like insert piece configured to be positioned around a portion of the head, wherein a lower edge of the insert piece extends past the lower opening when the insert piece is seated in the receiving part a pressure member configured to contact the head to exert pressure onto the head wherein when the head, the insert piece, and the pressure member are arranged in the receiving part, the insert piece is tiltable with respect to the receiving part and with respect to the anchoring element, and wherein the anchoring element and the insert piece can be locked at respective angles relative to the receiving part.
