The most common causes of degenerative narrowing of the spinal canal are disc herniations and spinal canal stenosis. The standard surgical procedure for lumbar spinal canal stenosis today is microsurgical, microscope-assisted decompression. Full-endoscopic decompression is now also technically feasible and more widespread because of the development of surgical access techniques and instruments. The use of the different access technique depends on the anatomic and pathologic inclusion and exclusion criteria. Sufficient decompression can now be achieved using full-endoscopic techniques in a standardized minimally invasive procedure. This article describes the technique for the full-endoscopic decompression of the lumbar spine.