Objective To study the clinical application of posterior approach microendoscopy in the treatment of lumbar spinal stenosis. Methods One hundred and forty-two cases of degenerate lumbar spinal stenosis were treated by posterior approach limited decompression, total or semi laminectomy and decompression, or fenestration decompression from February 2000 to December 2001. Results Out of the 142 cases, posterior approach microendoscopic limited decompression was completed in 87 cases with full decompression obtained.Follow-up for a mean of 18 months in 82 cases revealed a rate of excellent-and-good of 92.7% (58 cases, excellent; 18 cases, good).No complications occurred. Conclusions Degenerate lumbar spinal stenosis, resulted from simple lumbar intervertebral disc herniation, hypertrophy of ligamentum flavumcan, and facet hypertrophy, can be effectively treated by posterior approach microendoscopic limited decompression. Proper selection of patients, full decompression and experienced operative skills are the key to satisfactory surgical results.