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Degenerative spondylolisthesis usually begins gradually and is characterized by being more of an ache than the pain of isthmus spondylolisthesis. Pain is usually in the lower back and posterior thighs. Symptoms are often chronic and progressive although some patients may experience remission. Neurogenic claudication (weakness or heaviness in legs) rather than radiculopathy may be the presenting pain pattern. Depending on the degree of spinal stenosis, reflexes in legs may be affected. In degenerative spondylolisthesis, the slip most often occurs between L4-L5.

Some patients with degenerative spondylolisthesis present with low back pain and arthritic changes while some present with signs of spinal stenosis, (e.g., buttock and leg pain in addition to low back pain). They experience relief from pain when they rest their spine or lean on something (e.g., supermarket wagon). Pain is mostly related to activity (e.g., walking). The nerve that is compressed is usually the L5 nerve root but L4 nerve root can be affected as well. Claudication occurs in approximately 15-20% of individuals and is usually mild.