Seventy-six operations were performed by the author for lumbar spinal stenosis syndrome over 25 years. The characteristic symptoms of pain, sensory changes, and intermittent pseudoclaudication in connection with the extent of nerve root compression confirmed by laboratory examinations and the operative findings allow the author to stress the following points. (1) In Greece, lumbar spinal stenosis syndrome is not a very common entity. (2) Spinal stenosis cases of acquired type are the most common while those of developmental character are very rare, only two in this series, (3) Surgical intervention, which is the treatment of choice, includes a generous decompressive procedure that must free all the neural elements. Sometimes it is necessary to remove part or all of the facets in one or more levels. (4) The rate of complications is low, and complications are of minor character. (5) The results on the whole are very satisfactory and lasting, provided the planning and execution of the operation are based on sound preoperative assessment using both clinical examination and laboratory investigation. (6) Development of the acquired form of stenosis of the spine seems not to be preventable. The pathogenesis of the syndrome has not been fully established.