In the study of painful lumbosacral complex spondylolisthesis as an etiological factor bound to congenital, traumatic and/or degenerative alterations must be considered. In some cases a discai protrusion is added to vertebral slipping and therefore radicular irradiation of lumbar disk protrusion develops on the clinical picture of vague and intermitent lumbar pain, characteristic of spondylolisthesis. Severe or mild vertebral trauma perform an important part in the development of the painful picture for they act upon defective congenital and/or altered spines. Thus, in a group of 27 patients, 13 had the traumatic evidence and 14 related small traumas which conditioned the appearance of or aggravated the pain. Functional radiologic examination is fundamental for the diagnosis and is completed by myelography in cases where a discai protrusion is suspected. The anterior or posterior surgical fixation of the lumbosacral spine, through autogenous graft or bone plus metalic graft, is the selected treatment in spondylolisthesis. Patients operated with Cloward's technique of inter-corporal grafts have a better evolution and quick recovery compared with other techniques or posterior arthrodesis. The treatment of spondylolisthesis requires a syncronized work of the neurosurgeon, traumatologist and radiologist.