A total of 60 patients with recurrent lumbar disc herniation (RDH) were enrolled in this prospective randomized comparative clinical study. Patients were randomly assigned to undergo either revision microdiscectomy alone (n=30) or revision discectomy with fusion (n=30). The primary outcome measure was the improvement in pain and disability following surgery. Secondary outcomes included operative data such as surgery time, blood loss, and hospital stay, as well as radiological outcomes assessing disc height index (DHI), foraminal height index (FHI), and subsidence. Clinical outcomes were evaluated preoperatively and at various intervals up to 24 months postoperatively. Overall, the results revealed that revision discectomy with fusion led to significantly better outcomes in terms of pain relief, disability improvement, and prevention of disc height subsidence compared to revision microdiscectomy alone.