Lumbar spinal stenosis typically manifests itself through low back pain and neurogenic claudication during walking. Cervical spinal stenosis may manifest itself through a multitude of symptoms. Spinal stenosis is classified into congenital or primary and acquired or secondary forms. Conventional X-rays of the spine often reveal only unspecific findings. Computed tomography (CT) is the preferred method of judging the width and anatomy of the spinal canal. Myelography remains a good method of imaging the spinal cord in its entirety and in addition allows functional imaging of the width of the spinal canal with functional stress images. CT performed directly after myelography (myelo-CT) allows specific imaging of areas still unclear. Magnetic resonance imaging (MRI) allows multiplanar imaging of the spine and better soft tissue definition. Surgical therapy is discussed in relation to the clinical and neuroradiological findings.