9 studies (857 patients) were included in this meta-analysis comparing decompression plus fusion to decompression alone for the treatment of lumbar spinal stenosis, with or without degenerative spondylolisthesis (DS). Outcomes of interest included back and leg pain, the Oswestry Disability Index (ODI), EQ-5D scores, patient's satisfaction, walking ability, incidence of complications, rate of adjacent segment degeneration, reoperation rate, DS progression, operative time, blood loss, and length of stay. Results found significantly favourable pooled results for operative time, blood loss and length of stay in the decompression alone group compared to the decompression plus fusion group. In contrast, the pooled results for adjacent segment degeneration were significantly in favour of the decompression plus fusion group. Pooled results for all remaining outcomes were not significantly different between the two groups.