Objective To evaluate the curative effect of selective window decompression surgery for over 80-year-old patients with mul-tiple segment lumbar spinal stenosis. Methods The patients received the operation through posterior median approach. The location of le-sions were determined according to patients' symptom,physical examination and imaging examination,the selective window decompression sur-gery was performed in patients,JOA scoring method was used to evaluating the effect of surgery. Results In the recent follow-up of first 6 months after surgery,the response rate of 52 patients with follow-up was 100%. During the mid-term follow-up after 24~36 months,the re-sponse rate of 47 patients with follow-up is 90. 4%,the average follow-up time was 30. 4 months. The preoperative JOA score and postopera-tive score were (6. 93 +0. 52) and (11. 98 +0. 72) respectively,of which 40 cases achieved optimal standard (76. 9%),10 cases (19. 2%) achieved a good standard,2 cases reached the standard (3. 9%),the excellent rate was 96. 1%. The JOA score of mid-term fol-low-up was (12. 06 +0. 46),of which 36 cases reached optimal standard (76. 6%),10 cases achieved a good standard (21. 3%), but standard was in 1 case (2. 1%),the excellent rate was 97. 9%. The difference of JOA scores was statistically significant (P<0. 01). Con-clusion Selective windowing decompression has the advantages of small trauma,short recovery time and satisfied curative effect,which is suitable for elderly patients with lumbar spinal stenosis.