Objective • The study aimed to evaluate the impact of OLIF on spinal-pelvic sagittal parameters and its correlation with clinical outcomes in patients with degenerative lumbar spondylolisthesis. Methods • A retrospective analysis of 43 patients (23 males, 20 females) with lumbar 4/5 degenerative spondylolisthesis who underwent OLIF from January 2018 to January 2023 was conducted. Key parameters studied included SP, DH, FH, AS, LL, SS, PT, PI, and LASD. Results • All surgeries were successfully completed according to the original plan, and the minimum followup time was greater than 6 months, with a mean operation time of 198.21±51.32 min; the mean intraoperative bleeding volume was 121.00±56.88 ml. The VAS score of lumbar pain and ODI index decreased from the preoperative VAS score, and the ODI index of lower lumbar pain from the preoperative VAS score of 6.50±1.36 and 74.36±6.27 to the postoperative Lumbar pain of 3.20±1.28 and 32.41±8.21, respectively, and the differences were statistically significant (P < .05). 6.27 to 3.20±1.28 and 32.41±8.21 at the final follow-up visit. The differences were statistically significant (P < .05). The results of Pearson correlation analysis showed positive correlation between postoperative LL and FH, SP and AS, VAS (P < .05), and service correlation between SP and SS, LASD (P < .05), and correlation between pre- and postsurgery difference of LL, FH, SP and the improvement rate of ODI and VAS scores (P < .05), with the difference of pre- and post-surgery difference of LL, FH and the ODI, VAS score improvement rate were the strongest correlation. Postoperatively, significant improvements were observed in LL and FH. Pearson correlation analysis indicated a positive correlation between changes in sagittal parameters and clinical outcomes, measured by VAS and ODI scores. Conclusion • The postoperative spine-pelvis sagittal parameters were significantly improved compared with the preoperative ones, and the changes of the spine-pelvis sagittal parameters before and after the operation were correlated with the clinical outcomes, among which the differences of LL and FH had the strongest correlation with the improvement rates of ODI and VAS scores. OLIF effectively improved spinal-pelvic sagittal parameters and clinical outcomes in degenerative lumbar spondylolisthesis, with changes in LL and FH showing the strongest correlation with patient-reported outcome improvements. An oblique lateral interbody fusion can effectively reconstruct spine-pelvis sagittal parameters in patients with degenerative lumbar spondylolisthesis. [ABSTRACT FROM AUTHOR]