Bertolloti syndrome is the association between low back pain (LBP) and the presence of a lumbosacral transitional vertebrae. A transitional vertebrae is composed of one or both transverse process connecting with the sacrum or ilium and the presence of a vestigial intervertebral disc space caudal to the transitional vertebrae. We experienced a case of low back pain with intermittent radiating pain in patient with complete lumbosacral sacralization. Long term relief of low back pain was maintained with intra and/or periarticular infiltration of local anesthetics and steroid. The relief of LBP suggests a correlation between LBP and lumbosacral sacralization.