Kanematsu R, et al. - Despite a few reports concerning radiofrequency treatment for Bertolotti’s syndrome (BS) presenting with low back pain, no previous report on pulsed radiofrequency (PRF) has been identified. Researchers here reported four patients (one woman, three men; average age 55 years, range 22–77 years) who presented with low back pain without radicular pain for a mean of 13.2 months (range 8.0–24.3 months). Of these patients, three had type IIA lumbosacral transitional vertebra according to Castellvi’s classification, and one had type IIB. Their low back pain relieved temporarily when injected with fluoroscopically guided local anesthetic injection into the pseudarthrosis, but subsequently, the pain returned. PRF treatment was then provided to each of these patients. To date, for a mean follow-up period of 8.2 months (range 3.9–10.4 months), the patients exhibited continued pain relief and full restoration of function. Hence for the low back pain associated with BS, PRF is a sufficiently effective, minimally invasive treatment option at least for the short term.