Lumbar microdiskectomy is indicated in patients with a symptomatic lumbar intervertebral disk herniation (IDH) that is refractory to a reasonable trial of nonsurgical treatment. Well-suited patients present with leg pain, or “sciatica,” that follows a clear-cut radicular pattern. A thorough history and physical examination can predict the level of the IDH before confirmatory imaging studies are obtained. Oral corticosteroids, nonsteroidal antiinflammatory drugs, physical therapy, and lumbar epidural steroid injection at the level of the IDH or affected nerve root are nonsurgical measures that are commonly used to manage pain and loss of function.