Upper lumbar spondylolysis is rare and there are few reports which describe the condition. Three patients with upper lumbar spondyloysis, two of whom underwent surgical treatment, are reviewed. A radiological review of 205 patients with back pain attending a Back Research Clinic revealed three additional patients with symptomatic upper lumbar spondylolysis. clinical diagnosis of this condition is often difficult and the results of operation are unsatisfactory. It is more common among men and trauma appears to play a major role in the production of symptoms.