Study Design. A retrospective review including patient follow-up on all lumbar decompression procedures by 1 of 2 surgeons. Objective. To evaluate the success of lumbar decompressions performed on an outpatient basis on patients 65 years of age or older. Summary of Background Data. The efficacy of decompression procedures on the lumbar spine is documented and is often performed on an outpatient basis. Few studies have evaluated these procedures in older adults, and none in a greater population of patients on an outpatient basis. Methods. A total of 1377 lumbar decompression procedures were performed from 1992 to 2001 by 2 surgeons, 263 of these on patients 65 years of age or older. A chart review was done on all procedures. Follow-ups occurred from June 2001 to August 2003 by an unbiased observer not involved in the surgical procedures. Results. A total of 30 (11.4%) of the 263 procedures were done with a hospital stay: 10 patients of 243 planned inpatient procedures (4.1%) were converted due to a complication. Of the 233 done on an outpatient basis, 4 (1.7%) had a complication. A total of 152 patients (57.8%) completed a questionnaire by phone or mail by an unbiased observer at least 18 months after surgery. A total of 97 of 134 patients (72.4%) said they would repeat the outpatient procedure, and 94 of 136 patients (69.1%) stated that their surgery's outcome was good or better. Conclusions. For the aged patient, surgical decompression of the lumbar spine can be performed on an outpatient basis safely and successfully.