In Brief A case is presented of a 66-year-old woman with degenerative spondylolisthesis in the lumbar spine who was treated with a custom lumbosacral orthosis. Qualitative results demonstrated an improved quality of life and reduction in pain. Quantitative results indicate that the orthosis reduced the sacrohorizontal angle without reducing lumbar lordosis. The ratio of shear to normal force at L5-S1 was reduced by 42%, and the patient reported an improved outcome. Reducing the ratio of shear to normal force is a quantifiable measure that plays an important role in relieving pain symptom and improving quality of life in degenerative spondylolisthesis. Degenerative changes in the spine often cause the loss of normal structure and/or function in a spinal segment or segments and can be painful. Many of these patients are not ideal surgical candidates, given their age and quality of bone. A case is presented of a 66-year-old woman with degenerative spondylolisthesis who was treated with a custom lumbosacral orthosis. Qualitative results demonstrated an improved quality of life and reduction in pain. Quantitative results indicate that the orthosis reduced the sacrohorizontal angle without reducing lumbar lordosis. The authors conclude that the orthosis was successful in that surgery was avoided, pain medication dependency was decreased, and quality of life was improved.