Sixty patients with single-level lumbar disc herniation undergoing unilateral biportal endoscopic discectomy were randomized to receive either an epidural steroid injection (n = 30) or saline placebo (n = 30) via catheter 2 hours postoperatively. The primary outcome was pain control assessed by visual analog scale (VAS) scores. Secondary outcomes included Oswestry Disability Index (ODI) scores, 24-hour morphine consumption, C-reactive protein (CRP) levels, and complications over 6 months. Overall, the results of the study revealed no significant differences in VAS scores, ODI scores, morphine consumption, or CRP levels between the ES and placebo groups at all time points. These findings suggest that routine epidural steroid use after UBE-D may not offer additional clinical benefit.