A 55-year-old lady presented with complaints of chronic low back pain with radiating leg pain for the past two years, which had significantly worsened over the last 24 hours, affecting her mobility and daily activities. Conservative management had failed to provide long-term relief. MRI of the lumbosacral spine revealed L4–L5 spondylolisthesis with disc degeneration and neural compression, consistent with her clinical symptoms. Based on detailed evaluation, she was diagnosed with L4–L5 Spondylolisthesis. The patient underwent minimally invasive endoscopic spinal fusion (Endoscopic TLIF) at Max Super Speciality Hospital, performed by Dr. Pramod Saini. The procedure was completed successfully using an advanced endoscopic technique, resulting in minimal muscle damage. The skin incision was approximately 1–2 cm, leading to reduced blood loss, less postoperative pain, and faster recovery. Post-surgery, the patient experienced significant improvement in pain and functional ability.