Background: retrolisthesis is the posterior displacement of one vertebral body in relation to the adjacent vertebrae to a degree less than a dislocation. However, lots of neurosurgeons consider retrolisthesis as incidental finding a rising prove that it is not a rare condition and a cause of many backaches. Aim of work: to compare between discectomy with or without fixation as regards to pain, function and rate of reoperation in patients with lumbar disc prolapse associated with retrolisthesis. Patients and Methods: This study is prospective and retrospective study in fifty cases of patients with single level of lumbar disc prolapse associated with retrolisthesis in Al-Azhar University hospitals and Health Insurance hospitals in time between 2018 and 2019. Twenty-four patients were undergone discectomy alone and 26 patients were undergone discectomy plus lumbar fusion surgery. Results: the main level of retrolisthesis is L5-S1 with higher incidence than other high levels. Sixty six percent (33 cases of 50) and conservative treatment plays an important role in initiation of treatment but surgery by discectomy and fixation according to case demand is the main convenient solution. Conclusions: In this study we showed that patients with lumbar disc prolapse with retrolisthesis should be managed by discectomy alone in cases presented with radicular pain more than low back pain with dynamic study shows no instability. And should be managed by discectomy and fixation in cases presented with low back pain more than radicular pain with dynamic study showing instability or MRI finding shows advancing facet arthritis.