Background: Low back pain is the most common musculoskeletal problem in the adult population with a worldwide prevalence is 50% to 84%. Lumbar canal stenosis is a chronic condition of low back pain characterized by narrowing of the spinal canal and neurogenic claudication is the most apparent symptom. This condition can improve with manual therapy using mobilization and exercise therapy. Case presentation: The patient is a 57–year–old male with a chief complaint of neurogenic claudication after five minutes of standing and walking since 3 months. The patient had developed a stooped posture to avoid pain and heaviness in the right leg. During first week, the mobility of thoracic spine was improved by mobilization, and posture was corrected. Flexion based exercise also was started. During second week, strengthening exercise of hip musculature was initiated. On the third week backward walking started with strengthening exercise. Complete recovery was achieved using manual therapy and exercise therapy after three weeks. Conclusion: This case report indicates the importance of thoracic and sacral mobilization with flexion based exercise and backward walking in a patient with lumbar canal stenosis to improve symptoms of neurogenic claudication.