The lumbar spinal stenosis is a radiological description of a pathology that can present clinically by a neurogenic intermittent claudication; its diagnosis is mainly clinical. After listing the main criteria allowing the clinician to make a diagnosis, a review of available treatments is proposed. There are few quality studies and an empirical approach is often necessary. In severe cases, very disabling despite correct treatment, a surgical approach may be considered and discussed with the patient to avoid failure, sometimes linked to excessive expectations.