Introduction: Low back pain is one of the most common health problems in the developed world that is associated with disability, lower quality of life, emotional disorders and absence from work. With most patients the pain resolves in the acute or subacute phase, in 2-7% of cases the pain progresses to the chronic phase. Physical activity is the most commonly used conservative method to treat chronic low back pain. Graded activity is a form of physical activity that consists of a graded exercise programme with operant conditioning principles and is time contingent. Purpose: The purpose of the study was to systematically review articles that studied the effectiveness of graded activity protocol in the treatment of chronic low back pain. Methods: The time frame used in this study was between the years 2004 and 2015. We searched articles in Slovenian, Italian and English with the following key words: graded activity, graded exercise, graded activity protocol, chronic low back pain, activity grading therapy, physiotherapy. A literature search of PEDro, Medline, CINAHL, Science direct and Cochrane databases was conducted to find randomized controlled trials. 72 articles were analyzed and scored on the PEDro scale. Results: 7 articles were included in the literature review, 4 compared graded activity with standard physiotherapy, 2 with others forms of physical activity and one with exposure in vivo. Patients in all treatments groups reported reduction of pain and disability. Results were clinically and statistically insignificant at all stages. Patients also reported lower levels of kinesiophobia and fewer days’ absence off work. These two measurements showed a statistically and clinically significant advantage of the graded activity protocol at all stages. Discussion and conclusion: Results showed that graded activity protocol is not more effective than other forms of treatment on reduction of pain and disability. Graded activity was more effective on the reduction of kinesiophobia. Patients that followed a graded activity protocol also reported fewer days off work. The results show that graded activity protocol should be considered when forming the treatment plan, especially when the patient shows higher level of kinesiophobia or is economically active.