Objective To study the application of multislice computed tomography (MSCT) sagittal reconstruction for real lumbar spondylolisthesis. Methods 93 cases with lumbar spondylolisthesis accepted 64-slice MSCT. Their routine CT axial images and sagittal reconstruction images of vertebrae disc were reviewed. Results 93 cases were found with the lumbar spondylolisthesis, 74 cases in class I and 19 cases in class II. 58 cases were found with spondylolisthesis for routine axial CT image. Conclusion MSCT sagittal reconstruction can display spondylolisthesis satisfactorily