Restless legs syndrome (RLS) is a neurogenic disorder with the patients having a sensation of discomfort and an urge to move continuously. These symptoms can get worse during night and cause sleep disturbance. These symptoms can be misdiagnosed as lower leg pain of a spinal origin and the treatment can be wrongly focused on this. This treatment for an unproven state of symptoms can place clinicians in a difficult situation. We experienced RLS associated with spondylolisthesis and spinal stenosis, and we originally misdiagnosed the patient and wrongly treated the patient operatively with spinal fusion and posterior instrumentation. After an insufficient result, we diagnosed the patient with having RLS with the help of the neurology department and rehabilitation medical department. In one other case we diagnosed a RLS patient with the help of a neurologist and the patients had arrived an our department for total knee arthroplasty and spinal root block. We report on these cases so other orthopedic surgeons will not make same mistakes.