Prospective cohort study. To report re-operation rates following lumbar tubular microdecompression (LTM) as well as compare patient reported outcomes (PROs) 6 years after surgery between those who did and did not need revision at the index level. Long term data describing PROs and re-operation rates following LTMs are lacking. Patients with lumbar spinal stenosis underwent one or more of three LTM procedures. Demographic, PROs [Oswestry Disability Index (ODI) and visual analog scale (VAS) for back and leg pain], and re-operation data were collected. Failure of an index LTM was defined as any revision surgery at the index level. Revision LTM at a different level was not considered failure. Failure and revision LTM incidence at a different level and cumulative incidence were prospectively collected up to six years. Mixed effects linear regressions with 95% confidence intervals (95% CI) were performed to assess potential differences in ODI and reported VAS back and leg pain between patients that reported failure and those that did not. 418 patients were included with median follow up of 3.0 (1.9, 4.1) years. 25% had a reoperation by 6 years. 65 (16%) failed and 35 (9%) underwent a second LTM at another level. Cumulative failure incidence was 9% within the first two years. Failure patients had a statistically higher ODI [12.1 (95% CI: 3.2, 20.1) and VAS back [2.3 (95% CI: 0.9, 3.8)] and leg pain [1.6 (95% CI: 0.2, 3.1)] throughout followup. The overall dural tear rate was 7.2%. LTM is an effective treatment for lumbar spinal stenosis with sustained 6 year PROs. Most failures occur within 2 years postoperatively and stabilize to 4% yearly incidence by year 5. The yearly incidence of re-operation with LTM stabilizes at 3% by year 6 post operatively. 2.