To document the natural history and outcomes of lumbar spinal stenosis in patients with neurogenic claudication, 47 patients who had been evaluated 5 years earlier were evaluated by telephone interview. Thirty-one were reexamined. The average duration of symptoms was 8 years. All patients had bilateral lower extremity symptoms, which were more pronounced unilaterally in three patients.Of the nonsurgically treated cases, 43% (20/47) improved; 30% (14/47) were unchanged. Seven of 11 patients treated with intermittent traction 1-2 times weekly improved walking tolerance and reported less back pain. Eight of 13 improved their walking tolerance after 1-3 epidural cortico-steroid injections. The 23% (11/47) who did not improve or worsened reported improvement after laminectomy.The majority of patients with symptomatic spinal stenosis will stabilize or improve without surgery. For those with intolerable symptoms, laminectomy can usually provide appreciable symptomatic relief.