Spondylolisthesis is a known source of chronic back pain due to spinal nerve root compression (Kraiwattanapong et al., 2014). It affects up to 8% of the adult population and is associated with disability, emotional distress, anxiety, and depression (Bouras & Korovessis, 2015; Kreiner et al., 2016; Hsu et al., 2019). Transforaminal epidural steroid injections (TFESI) allow precise delivery of corticosteroids to affected spinal nerves resulting in decreased inflammation and pain (Morgan & Mikhail, 2013). The purpose of this systematic review was to evaluate the efficacy of TFESI as method of pain management in symptomatic lumbar spondylolisthesis. A detailed search was conducted using CINAHL Plus, Google Scholar, Medline, and PubMed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework guided this systematic review. Critical Appraisal Skills Programme (CASP) checklists were used to evaluate article reliability. Data extracted from included studies focused on purpose, design, sample, method, limitations, steroid administered, number of injections, follow up interval, and pain scores. Study demographics, outcomes, and cross-sectional analysis tables were created to facilitate the interpretation of collected data. This systematic review concluded that further statistically significant research is needed to confirm the efficacy of TFESI in treating spondylolisthesis related radiculopathy.