200 patients with large uncontained lumbar disc herniation were randomized to either open (OPEN) or microendoscopic discectomy (MED). The purpose was to compare clinical outcomes of both techniques over an 8 year period. Clinical measures included the Numerical Rating Scale (NRS) for leg and back pain, as well as the Oswestry Disability Index (ODI). After 8 years, NRS leg and back pain were lower in patients who underwent microendoscopic discectomy, as was ODI score. Secondarily, blood loss, length of hospital stay, and return to work were all reduced within the MED group compared to the OPEN group.