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In the present paper, we are to review the diagnostic role of US in patients with LBP arising from a handful of common etiologies, which have been debated in the literature. 2. Evidence Acquisition Literature searches were conducted in December of 2012 on all accessible library databases of published research reports available at Tehran University of Medical Sciences' library. No date limit was applied to any of the databases searched, thus each database was searched since its inception. The electronic databases included: PubMed (1950 to present), Ovid SP Medline (1950 to find protocol present) and ISI (1982 to present) and Google Scholar. In every search engine another search Enol was performed using various permutations of the following keywords: ultrasonography, ultrasound imaging, low back pain, back muscles, paraspinal muscles, multifidus, transverse abdominis, muscle size, spinal canal, sacroiliac joint and spondylolisthesis. Secondary searching (or PEARLing) was however undertaken, whereby the reference lists of the selected articles were reviewed for additional references not identified in the primary search. The full text of all potentially relevant articles were retrieved and screened by the authors, in order to determine the eligibility of the paper for inclusion in the review. 3. Results 3.1. Ultrasonography and Spinal Canal Diameter Employing US in measurement of spinal canal diameter was firstly reported by Porter et al. (24) who measured the diameter of spinal canal by placing the transducer of ultrasound in an oblique midsagittal plane 1 centimeter lateral to midline (24, 26-28). Porter et al.(24) reported that spinal diameter in trefoil shaped vertebras such as L5 is less than other vertebras and the incidence of LBP due to bony stenosis or laminar hypertrophy might be more in trefoil shaped vertebrae in comparison to other vertebrae. Porter et al.(26) also found that mean spinal canal diameter in patients with LBP was 1.44 click here cm, compared to a diameter of 1.61 in normal subjects and this difference was found to be statistically significant. It was suggested that a diameter of