To evaluate the relationship between the degenerative lumbar spondylolisthesis (DLS) and L4 inclination angle (IA) and evaluate the risk factors of DLS. Ninety L4-5 DLS patients and ninety L4-5 lumbar disc herniation or spinal stenosis patients (control group) were compared. Parameters include L4 IA, FJA, cross-sectional area (CSA) of paraspinal muscle, Pfirrmann grading of intervertebral disc (ID) and degeneration grading of facet joint (FJ) were evaluated. Student's t-tests and Logistic regression analysis were used to analyze the risk factors of DLS. Statistical differences were found in L4 IA CSA of multifidus muscle FJA and degeneration grading of FJ between two groups. (p<0.001, p=0.07, p<0.001 and p<0.001 respectively). The logistic regression analysis demonstrated that higher L4 IA (β: -0.186, p<0.001), more sagittal FJ (β: -0.117, p<0.001) and more severe degeneration of FJ (β: -1.033, p<0.001) were both significant predictors of DLS. Patients with L4 IA more than 11.15° and FJA more than 60.19° are more likely to occur DLS. Copyright ? 2019 Elsevier Inc. All rights reserved.