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Two hundred seventy consecutive patients operated upon by standard discectomy were compared to 270 patients treated with microlumbar discectomy. All patients had back and leg pain, as well as positive clinical findings and positive myelograms suggestive of disc herniation. The results demonstrated a 98% success rate in the microsurgical group as compared to a 95% success rate in the standard laminectomy group. Of microdiscectomy patients, 95% had an excellent result, as compared to 89% of the standard laminectomy group. Patients with pending compensation cases did only slightly poorer than those with no secondary gain regardless of what procedure was used. The postoperative hospital stay of the microsurgical patients averaged 3.7 days as compared to 7.1 for the standard technique. The time before return to work was significantly shorter in patients undergoing microdiscectomy. Microdiscectomy proved to be superior in both clinical results and cost effectiveness.