A polyaxial bone anchoring device including an anchoring element (1) having a shaft (2) for anchoring in the bone and a head (3), the head having a spherically-shaped outer surface portion (3a) a receiving part (4, 4, 4") pivotably connected to said head (3), the receiving part having a top end (4a) and a bottom end (4b), a longitudinal axis (C) extending through the top end and the bottom end, a transverse channel (9) for receiving a rod (100) and an accommodation space (11, 11, 11") for accommodating the head (3), the accommodation space (11, 11) having a lower opening (12) at the bottom end (4b), a sleeve-like insert piece (5) encompassing a portion of the head (3) having an outer spherical surface portion (51) and being configured to pivot in the receiving part, wherein a lower edge (5b) of the sleeve-like insert piece (5) extends through the lower opening (12) when the sleeve-like insert piece is seated in the receiving part in a position in which its sleeve axis (5c) is coaxial with the longitudinal axis (C) a pressure member (6, 6, 6", 6), the pressure member being arranged at least partially in the accommodation space (11, 11, 11"), wherein the pressure member has a lower surface portion (61) that contacts the head (3) to exert pressure onto the head wherein the anchoring element (1) is pivotable with respect to the receiving part (4, 4, 4") and can be locked at an angle by exerting pressure with the pressure member (6, 6, 6", 6") onto the head (3) to lock the head and the sleeve-like insert piece (5) simultaneously in the receiving part.
