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. A pivoting member is disposed with the carrier and relatively moveable therefrom. A distal portion defines a longitudinal axis and is configured to penetrate tissue. 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.