Background: Spondylolysis is a fatigue fracture which occur in the pars interarticularis due to repetitive mechanical stresses on the lumbar spine. Objective: This work was aimed to discuss the different methods in management of spondylolysis, regarding the conservative treatment and surgical procedures. Patients and methods: This study included 30 cases with spondylolysis at Al-Azhar University Hospitals. 13 cases were operated upon in El-Sayed Galal Hospital of Al-Azhar University and 12 cases were operated upon in El-Hussin Hospital of Al-Azhar University with 5 cases were managed by conservative treatment between August 2017 and July 2019. Follow up was done for average one year. Results: The improvement of radiculopathy in our study was ranging into 3 category: Fair improvement (2 cases, 20%) with conservative treatment, Good improvement (2 cases, 20%) with decompression and fixation, and Excellent improvement (6 cases, 60%) also with decompression and fixation, so there was a statistical significant relation between both strategy (p-value=0.007), which indicate that the spondylolysis with radicular pain is better managed by decompression and fixation. In our study, we used the Visual Analogue Scale (VAS) in the all cases pre management and post management to assess the outcome. In our study, there was a significant change in Mean VAS score with mean VAS pre-management 7.1, mean VAS post management 2.6 and mean difference in VAS 4.5. Indicating a significant improvement of pain intensity (P<0.001). Conclusion: Spondylolysis is common in young females at L5 pars and presented with LBP in most cases. Different surgical procedure is safe and effective in management than conservative treatment.