Researchers conducted a retrospective analysis of data gathered prospectively. For a study, the researchers sought to determine how different combinations of preoperative back pain (BP) and leg pain (LP) affected functional outcomes, patient satisfaction, and return to work (RTW) in degenerative spondylolisthesis patients who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Data from patients who had primary MIS-TLIF for degenerative spondylolisthesis were analyzed. Patients were divided into 3 groups based on their primary source of pain: leg pain (LP>BP), back pain (BPP; BP>LP), and equal pain predominance (BP=LP). Patients were followed for at least 2 years prospectively. A total of 781 individuals were included in the study, with 33.4% having LP predominance, 28.7% having BPP, and 37.9% having equal pain predominance. The BPP group was younger (P=0.005) and had a trend toward a lower baseline Short-Form-36 Mental Component Summary (P=0.069). After accounting for baseline differences, there was no significant difference in blood pressure, lung capacity, Oswestry Disability Index (ODI), SF-36 Physical Component Summary, or SF-36 Mental Component Summary between the 3 groups at any time point (P>0.05), except for the BPP group’s poorer 1-month ODI (P=0.010). The rates of ODI and SF-36 Physical Component Summary satisfaction, expectation fulfillment, and RTW were likewise similar (P>0.05). Regardless of the significant pain location, functional results, quality of life, and satisfaction following MIS-TLIF were identical. An equal number of patients attained the minimal clinically relevant difference and RTW. The outcomes imply that MIS-TLIF could be equally successful for patients with varied combinations of BP or LP when used in the context of practical reasons.