Background: Spondyolisthesis, a forward slip between one vertebrae relative to another, usually occurs in the lower part of the lumbar spine area. Among the main causes of spondylolisthesis is spondylolysis, a separation in a vertebral arch between the corpus and the spinous process. No articles were identified that discussed the use of acupuncture to treat spondylolisthesis. Objective: To describe the acupuncture treatment of 2 patients with back pain due to spondylolisthesis. Design, Setting, and Patients: Case descriptions of 2 affected patients: one with a 40-year history of low back pain and the other with a 4-year history of low back and leg pain. Both were treated by the author at a Traditional Chinese Medicine clinic in Australia. Both patients were followed up through 2007. Intervention: For patient 1, bilateral acupuncture needling at BL 23 Shenshu, BL 25 Dachangshu, and BL 40 Weizhong. Electroacupuncture frequency for this patient was 50 Hz. Acupuncture treatment was every 5 days. A similar approach was used for patient 2, with standard 20-minute sessions 2 times weekly for 6 weeks. Main Outcome Measure: Patient report of symptoms after treatment. Results: In patient 1, after 2 acupuncture treatment sessions, the patient's back pain, left heel pain, and left back muscle spasms disappeared. Ten more sessions were given once a week during the course of treatment. At follow-up 3 years later, the patient still reported no symptoms, including any symptoms of chronic low back pain experienced 40 years previously. Patient 2 had recurrences of similar symptoms 1 and 3 years after treatment. Similar treatment courses were used to stabilize the condition. He has had no recurrences for more than 3 years. Conclusions: The conditions of these 2 patients stabilized after treatment. However, more case reports or clinical trials are needed to assess the benefits or mechanisms of acupuncture treatment.