A bone fastener comprises a proximal portion including an extension that includes an inner surface defining at least one projection. A pivoting member is moveable relative to the proximal portion. The pivoting member includes a first surface that defines an implant cavity with the inner surface of the proximal portion. A component is configured for disposal of the extension and includes at least one planar surface. A distal portion has a first end and a second end configured to penetrate tissue. The first end includes at least one planar surface configured to engage the at least one planar surface of the component. The proximal portion is rotatable relative to the distal portion in a first plane of a body and the pivoting member is rotatable relative to the proximal portion in a second plane of the body. Methods of use are disclosed.