With the widespread prevalence of back pain, and approximately 200,000 lumbar spine operations annually in the United States, imaging of the postoperative lumbar spine has become a major diagnostic issue. The many causes of the failed back surgery syndrome make the diagnosis of the etiology of the patient's symptom complex very important to the treating physician. With the varied types of surgery, the increasing use of fusion hardware, and the myriad of complicating factors, the imaging strategy must be flexible enough to be comprehensive in the evaluation of these difficult patients. This article will address the normal and abnormal findings after lumbar spine surgery.