Lumbar spinal stenosis refers to the narrowing of the central spinal canal, lateral saphenous nerve root canal, and intervertebral foramen of the lumbar spine caused by various reasons, and the narrowing and volume reduction of different parts of the spinal nerve channels leading to mechanical compression of the spinal nerve structures and a series of back and leg pain and neurological symptoms, called lumbar spinal stenosis. Due to the narrowing of the nerve pathways, the spinal cord, cauda equina and spinal nerve roots are compressed, resulting in reduced arterial blood flow, restricted venous return and local stagnation, reduced effective blood supply to the nerve tissue and tissue hypoxia, which is an important cause of low back pain. The causes of lumbar spinal stenosis include primary or secondary factors, congenital factors such as developmental spinal stenosis, and acquired factors mostly degenerative changes such as disc herniation, small joint coalescence and thickening and calcification of the ligamentum flavum. The typical symptom of lumbar spinal stenosis is low back pain characterized by intermittent claudication of neurogenic origin. Typical intermittent claudication refers to the gradual onset of unilateral or bilateral lower limb soreness and pain, numbness and weakness after walking for a period of time, to the point of claudication and inability to continue walking. However, after resting for a few moments in a squatting, sitting or bending forward position, the symptoms can be quickly relieved or disappear, and the patient can continue walking, and then after walking a certain distance, the same symptoms will soon appear again. The claudication appears intermittently, so it is called intermittent claudication, which seriously affects the patient’s daily activities, and in severe cases, symptoms can appear after walking several meters or tens of meters. However, in the resting state, there are mostly no symptoms and no obvious positive signs on physical examination. If lumbar spinal stenosis is suspected based on the symptoms, CT and MRI of the lumbar spine can be performed promptly to clarify the diagnosis. However, neurogenic intermittent claudication caused by lumbar spinal stenosis must be differentiated from vascular intermittent claudication caused by arterial stenosis and occlusion of the lower limbs to avoid misdiagnosis. Depending on the severity of lumbar spinal stenosis different treatment options can be chosen, including non-surgical conservative treatment and surgical treatment. Non-surgical treatment methods include: activity restriction, rest, medication and rehabilitation, which generally have more definite efficacy for patients with less severe spinal stenosis, less obvious nerve compression and less severe symptoms. There are many ways of surgical treatment, and the general principles of surgical treatment are: decompression, fixation, and fusion. Decompression means creating more space for the nerve and removing all factors that cause compression to release the spinal cord and nerve compression. Open surgery removes more bony structures that affect the stability of the spine and can be performed by internal fixation with an arch nail and intervertebral fusion. In recent years, good results have been achieved with flexible fixation and non-fusion procedures that preserve the intervertebral disc. Minimally invasive spine surgery and endoscopic spine surgery are also well developed and can address the causes of lumbar stenosis with good clinical outcomes. The choice of surgical procedure should be determined according to the actual situation of the patient, and the best surgical procedure is the one that suits the patient.