The third lumbar transverse process syndrome is a common disorder causing lower back pain, which is caused by irritation of the adjacent nerve fibers due to pulling of the transverse process of the third lumbar vertebra and the nearby tissues. The third lumbar vertebra is located in the center of the five lumbar vertebrae and is more mobile, and its transverse processes are often thicker and longer on both sides. The transverse process has the starting point of the psoas major and psoas square, and the deep fascia of the transversus abdominis and latissimus dorsi is attached to it, which is an important part for bearing and transmitting force. When the lumbar and abdominal muscles contract strongly, the force here is the greatest, and it is easy to tear from the attachment point to cause injury. The traumatic inflammatory reaction after muscle injury can cause bone hyperplasia, and can also stimulate the adjacent nerve fibers and produce low back pain. Typical clinical manifestations are low back pain and a distinct pressure point at the transverse process of the third lumbar vertebra, and in a few cases, pain at the root of the thigh. Sometimes the straight leg raise test may be positive, but the strengthening test is usually negative. In general, the condition can improve with proper rest, massage, physiotherapy, functional exercise, and closure. When the symptoms are heavy and conservative treatment is ineffective, surgery can be performed. The common surgical methods include transverse process muscle stripping, transverse process resection, lumbar dorsal fascia tear repair and cutaneous nerve dissection, etc. However, the indications for surgery should be strictly controlled.