A polyaxial bone anchoring device is provided including an anchoring element (1) having a shank (2) for anchoring in the bone and a head (3), the head having a spherical outer surface portion that includes a largest outer diameter (E) a receiving part (5) having a top end (5a) and a bottom end (5b), a channel (12) for receiving a rod therein, a bore (51) extending from the top end (5a) in the direction of the bottom end (5b), the bore having a bore axis (C) and a seat portion (52) for receiving the head at the bottom end, wherein at least two circumferentially distinct recesses (55) are provided in the seat portion a pressure element (6) arranged within the bore on top of the head, the pressure element (6) having a head contacting surface portion (62, 63) that contacts the spherical outer surface portion of the head (3), wherein the head contacting surface portion includes at least two circumferentially distinct lugs (63) that extend along a region of the head that includes the largest outer diameter (E) in an axial direction wherein the head (3) is pivotable with respect to the receiving part (5) and can be fixed at an angle by exerting pressure via the pressure element (6) onto the head, and wherein the pressure element (6) is configured to have an undersize with respect to the head only in a region of said lugs (63), such that when the pressure element is placed onto the head, the head is clamped by the friction between the spherical outer surface portion and the lugs and wherein the lugs are configured to extend at least partially into the recesses (55).
