Lumbosacral Transitional Vertebrae (LSTV) is the rare medical term used to describe congenital or acquired of the lumbosacral vertebral junction abnormalities associated with or without pain at the lower back (Almeida, et al. [1]).Early Identification, effective care, and treatment outcomes depend upon the diagnostic classification of LSTV.The incidence as low as 7% and 5.9%, respectively [3,4] and another study observed a rate of 30% of ABSTRACT Background: The lumbosacral transition vertebra (LSTV) is a rare anatomical variation of the lumbar vertebra characterized by pseudo formation of the transverse process between the lumbar vertebra and the sacrum or ilium with or without vari- ous symptoms including pain at back or buttock, movement difficulties, range of mo- tion limitations, postural problem, anatomical shifting or deviation, biomechanical alteration and leg pain.LSTV commonly presents as fusion of the transverse processes between the lumbar vertebra and the sacrum or ilium [2].As a result, the LSTV divided into four categories