Uninstrumented in-situ fusion of pediatric spondylolisthesis harbors a significant risk of suboptimal outcome. We suggest that reduction and instrumented fusion with deliberate protective measures against neurologic insult should be considered for the treatment of low-grade slips to intermediate-grade slips. This retrospective review of the clinical and radiographic data of 13 consecutively treated pediatric patients describes our experience with this approach. Eleven patients were pain free at the most recent follow-up and showed an average sustained correction in percent slip of 39%. This technique provides a safe alternative to in-situ fusion with the potential for improved outcomes.