Objective. The purpose was to compare the clinical effects of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar disc herniation (LDH) complicated with spinal stenosis. Methods. 96 LDH patients complicated with spinal stenosis treated in our hospital (April 2018–April 2020) were chosen as the subjects, and split into the PLIF group and the TLIF group according to different surgical approaches, with 48 cases in each group. The clinical effects of the two groups were compared. Results. There was no significant difference in hospitalization time between the two groups ( P > 0.05 ). Compared with the PLIF group, the TLIF group had obviously shorter operation time and greatly lesser intraoperative blood loss ( P < 0.05 ). The Numerical Rating Scale (NRS) scores of lower limb pain and low back pain in the two groups at 3 months after surgery were significantly lower than those before surgery ( P < 0.001 ). The Japanese Orthopaedic Association (JOA) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( P < 0.001 ). The Spitzer Quality of Life Index (SQLI) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( P < 0.001 ). Conclusion. The two surgical approaches have similar efficacy in treating LDH complicated with spinal stenosis. However, PLIF is better than TLIF in terms of operation time and intraoperative blood loss, which should be adopted as the preferred surgical scheme.