It has been shown that complex fusion procedures are increasingly applied to treat patients with lumbar spinal stenosis (LSS). However, no studies so far have proven that surgical treatments are indeed more effective than conservative treatments in LSS. This study systematically reviewed literature to compare the effects of surgical and non-surgical treatment in LSS. It could not be concluded that either surgical treatment or a conservative approach is better for lumbar spinal stenosis. However, the surgical approach showed higher side effects, whereas no side effects could be reported in conservative treatment.