Degenerative spondylolisthesis is one of the most commonly treated disorders in the adult spine surgeon's practice. However, in spite of the high prevalence of this disorder, there is no uniform agreement among surgeons about optimal treatment. This paper reviews the current literature regarding treatment options. Three key points were found. First, evaluation of available outcomes data reveals that surgical treatment of patients with symptomatic degenerative spondylolisthesis is superior to nonsurgical care. Second, when traditional laminectomy is performed in patients with degenerative spondylolisthesis, adding a spinal fusion appears to improve the outcome of surgery. Last, reliable assessment of the effectiveness of other surgical interventions such as intraspinous spacers and dynamic stabilization will require better designed studies that directly compare these techniques to other, more established, procedures.