Background: Symptomatic isthmic spondylolisthesis may cause back and or leg pain that usually needs surgical intervention. The question is what type of surgical treatment option to choose? A good option is the minimal invasive lumbar interbody fusion (MIS-TLIF) with a similar or to somewhat better results than the traditional open-TLIF. Aim: To evaluate the results of MIS-TLIF in management of isthmic spondylolisthesis. Methods: This is a prospective clinical trial. Between December 2017 to December 2019, 24 patients having a low-grade isthmic spondylolisthesis were subjected to MIS-TLIF surgery in the Spine Unit of the Orthopedic Department, Zagazig University Hospital. Osteotomy of the facet complex, preparation of the disc space and cages insertion was done, with per-cutaneous pedicle screw fixation. Demographic data, radiological imaging, visual analogue scale (VAS) and oswestry disability index (ODI) were collected. Twelve months was the least follow-up period. Results: The mean slip reduction changed from 23.13% to 6.48%. The mean VAS for back and leg pain improved from 8.42 to 1.79 and from 7.46 to 1 respectively. The mean ODI decreased from 52.21 to 15.71 at the outcome. No implant failure was documented in our patients. Our mean operative time was 110. 20 ± 13.39 minutes, mean radiation exposure was 3.79 ± 0.83 minutes and mean blood loss was 56.45 ± 14.63 ml. The fusion rate was about 95.8%. Conclusions: MIS-TLIF for low-grade isthmic spondylolisthesis provided a good clinical outcome and good fusion rate. MIS-TLIF can restore and maintain an adequate sagittal vertical access (SVA)