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Objective: To comparison the clinical efficacy and safety of transforamina 1 lumbar interbody fusion and posterior lumbar interbody fusion in treating patients with degenerative lumbar spondylolisthesis combined with lumbar spinal stenosis. Methods: A total of 90 patients with degenerative lumbar spondylolisthesis combined with lumbar spinal stenosis in our hospital from June 2013 to June 2015 were enrolled in this study. The subjects were divided into TLIF group (n=45) and PLIF group (n=45) randomly. The TLIF group were treated with TLIF. the PLIF group were treated with PLIF. The operation time, intraoperative blood loss, postoperative flow and postoperative time in bed of the two groups were compared. The VAS score and ODI score of the two groups before and after treatment were compared. The complications such as nerve root injury, infection and epidural cyst rupture of the two groups after treatment were compared. Results: The operation time, intraoperative blood loss, postoperative flow and postoperative time in bed of the TLIF group were ignificantly lower than that of the PLIF group (P<0.05). There were no significantly differences of the VAS score and ODI score of the two groups before treatment (P>0.05). After treatment, the VAS score and ODI score of the two groups were significantly lower than before treatment, and that of the TLIF group were significantly lower than the PLIF group (P<0.05). The incidence of adverse reactions after treatment of the TLIF group was significantly lower than that of the PLIF group (X2=3.873. P=0.049). Conclusion: Compared with PLIF. TLIF for patients with degenerative lumbar spondylolisthesis combined with lumbar spinal stenosis have good clinical efficacy and security, can help the recovery of the lumbar fuction. it was worthy clinical application. [ABSTRACT FROM AUTHOR]