Unilateral laminotomy with bilateral decompression (ULBD) is a technique similar to open or tubular decompression where, after unilateral laminotomy, sublaminar decompression is done for over-the-top and contralateral lateral recess decompression [1, 2]. This technique not only provides excellent pedicle to pedicle decompression under continuous endoscopic visualization but also prevents any damage to midline structures like the spinous process and supra- and interspinous ligaments and minimal undercutting of bilateral medial facets. Maintenance of these stability providing structures ensures that there is no iatrogenic instability and even in multilevel decompression alleviates the need for preemptive instrumented stabilization [3–5].