The authors analyzed the long-term results of surgical treatment 47 patients with true spondylolisthesis. The follow up period ranged from 14 to 25 years. All patients underwent an isolated anterior interbody riving allograft fusion. The scales of VAS and ODI were used for subjective assessment of treatment outcomes; objective assessment was based on clinical and radiographic, CT and MRI outcomes. There were 42.6% (20 cases) patients with good, 31.9% (15 cases) with satisfactory and 25.5% (12 cases) unsatisfactory results in the long-term follow-up. The main reasons of poor outcome were: the continued high degree of displacement of the vertebral body (17.6%), instability (38.3%) and the disbalance of the lumbosacral spine (63.8%), persistent compression of neural structures (42.6%). Most patients had the combination of these factors that were existed against backdrop of progressive degenerative changes of the spine.