Background:Lumbosacral anterolisthesis associated with degenerative disc disease is a common cause of chronic low back pain, leading to functional limitation and reduced quality of life. Conventional management often includes analgesics, physiotherapy, or surgical intervention in advanced cases. In Ayurveda, such conditions can be correlated with Katigata Vata, where vitiated Vata Dosha affects the lumbar region, resulting in pain, stiffness, and restricted mobility. Shalya Tantra offers para-surgical interventions like Agnikarma and Viddha Karma, which are indicated in localized Vata disorders and chronic musculoskeletal conditions. Case Presentation:A 37-year-old female presented with complaints of chronic low back pain, stiffness, and difficulty in prolonged standing and forward bending for several months. MRI findings revealed Grade I anterolisthesis of L5 over S1 with associated degenerative disc disease at the lumbosacral level. Clinical examination showed localized tenderness in the lumbosacral region and restricted range of motion without significant neurological deficit. Intervention:The patient was managed with an integrative Shalya-based approach. Agnikarma was performed on Day 1 and Day 7 at specific lumbosacral points. Viddha Karma was administered daily from Day 8 to Day 14 at local and radiating pain points. Supportive therapies including Kati Basti and Upanaha Swedana were given from Day 2 to Day 6. Internal medications like Yograj Guggulu, Dashamoola Kwatha, and Lakshadi Guggulu were prescribed for 15 days. Conclusion:This case demonstrates that Agnikarma and Viddha Karma, as Shalya-based para-surgical interventions, can be effective in managing lumbosacral anterolisthesis with degenerative disc disease. The integrative approach provided symptomatic relief, improved function, and may help in preventing disease progression.