Background: Lumbar intervertebral disc prolapses, commonly known as herniated disc, is a leading cause of chronic lower back pain and radicular pain, often necessitating surgical intervention when conservative treatments fail. This study compares the outcomes of unilateral fenestration and discectomy (UFD) versus bilateral fenestration and discectomy (BFD) in treating lumbar intervertebral disc prolapse. Objective: To evaluate the effectiveness of UFD and BFD in terms of pain relief, functional improvement, complication rates, and recovery times. Methods: This prospective study involved 200 patients diagnosed with single-segment lumbar disc herniation from January 2012 to December 2017. Patients underwent conservative treatment before surgical intervention. Group A received UFD, while Group B underwent BFD. Pain severity was assessed using the Visual Analogue Scale (VAS), and functional recovery was evaluated using the Oswestry Disability Index (ODI). Statistical analyses were performed using SPSS 19.0 software. Results: Group A (UFD) demonstrated superior perioperative and postoperative outcomes compared to Group B (BFD). Although demographic variables and herniation patterns were comparable between groups, Group A exhibited shorter surgical duration, lower intraoperative blood loss, and reduced postoperative analgesic requirements. Hospital stay and bed rest duration were significantly shorter in Group A, indicating faster recovery. Preoperative VAS-LP, VAS-BP, and ODI scores were similar in both groups; however, Group A showed greater reductions in pain and disability scores at early and late follow-up. Additionally, fewer postoperative complications were noted in Group A. These findings suggest that UFD leads to more efficient surgical recovery and improved early functional outcomes compared to BFD. Conclusion: UFD (Group A) provides clear advantages, including lower postoperative pain levels, reduced blood loss, shorter hospital stays, and faster overall recovery. These findings support UFD as a preferable surgical approach for appropriately selected patients, owing to its less invasive nature and superior short-term outcomes.