A rod reduction instrument (100) with a ratchet lock-out mechanism includes an inner shaft (101), an outer housing (110) and a ratchet mechanism (120). The inner shaft includes a threaded proximal portion (102) and a distal end that includes a plurality of engagement members (103) adapted to receive a pedicle screw. The outer housing is slidably received over the inner shaft, and includes a top sleeve (115) and a bottom sleeve (111). The top sleeve includes the ratchet mechanism to selectively engage the threaded proximal portion of the inner shaft and the bottom sleeve engages a connecting rod. The ratchet mechanism includes an engagement feature (141) to selectively engage the threaded proximal portion of the inner shaft, and a locking mechanism (130) to selectively lock the engagement feature of the ratchet mechanism against the threaded proximal portion of the inner shaft.
