A bone fastener comprises a proximal portion including an inner surface that defines a cavity. A carrier is disposed in fixed engagement with the inner surface and includes at least one arm defining a proximal face. A pivoting member is disposed with the carrier. The pivoting member defines an implant cavity with the proximal portion. A distal portion defines a longitudinal axis and is configured to penetrate tissue. The bone fastener further includes a first coupling member. 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. The first coupling member is engageable with the proximal face such that the carrier engages the distal portion to fix the bone fastener in an orientation. Methods of use are disclosed.