Lumbar degenerative spondylolisthesis, one of the most common causes of low back pain, is treated with high success rates with surgical treatment options. There are many treatment options such as simple decompression, instrument-less fusion, posterior instrument fusion, minimally invasive methods, 360-degree fusion with the addition of interbody fusion methods, and stabilization with dynamic instrument systems. High-quality studies have not yet demonstrated the absolute indications and superiority of these treatment methods to each other. Simple decompression without fusion should not be performed in cases where excessive movement is present, disc height is high, or extensive decompression is performed. Stabilization with the instrument system is the reference treatment method, and many studies have demonstrated its long-term effectiveness. Minimally invasive surgical methods have similar clinical results in interventions for a single level but lead to better results in interventions for two levels. There are studies in which non-fusion dynamic stabilization is used in degenerative lumbar spondylolisthesis, and positive results are reported. When deciding on the segments to be included in the fusion, it is necessary to pay attention to the global and segmental sagittal alignment. Each patient should be evaluated individually, taking into account clinical, radiological, sociodemographic characteristics and personal preferences, and the patient himself should be involved in the decision.