Abstract Background: Sciatica due to lumber spondylolisthesis is an important medical and socioeconomic problem that affects the quality of life. The most important symptom is radiating leg pain. Aim of Study: The current study was conducted to deter-mine the effect of L4 mobilization and posterior pelvic tilting exercise on sciatica in spondylolisthesis. Material and Methods: This study was conducted on sixty female patients with unilateral sciatica. Their ages ranged from 45 to 65 years. They were randomly assigned into four equal groups: Group (A): Received a designed physical therapy program (ultrasound and transcutaneous electrical stimulation). Group (B): Received designed physical therapy as (group A) in addition to doing posterior pelvic tilting exercises. Group (C): Received designed physical therapy as (group A) in addition to receiving lumber mobilizations on L4 vertebra. Group (D): Received designed physical therapy as (group A) in addition to combination between lumber spine mobilizations on L4 and posterior pelvic tilting exercises. Each patient in the four groups was evaluated by visual analogue scale to assess pain, lumbosacral X-ray to assess spondylolisthesis and Roland Morris Disability Questionnaire to evaluate the patient's functional disability before and after four weeks of treatment. Results: Group (A) showed a significant decrease in sciatic scale by 6.29% and RDQ by 9.09%. Group (B) showed a significant decrease in sciatic scale by 27.77% and RDQ by 38.94%. Group (C) showed a significant decrease in sciatic scale by 11.81% and RDQ by 20.65%. Group (D) showed a significant decrease in sciatic scale by 46.31% and RDQ by 54.88%. Conclusion: L4 mobilization and posterior pelvic tilting exercise has a significant effect in improving back function and sciatica.