[Objective] To explore the impact of preoperative depression on patients’ satisfaction and clinical outcome after surgical treatment for lumbar spinal stenosis (LSS) . [Methods] A total of 126 patients who underwent transforaminal lumbar interbody fusion (TLIF) for single-segment LSS from January 2016 to December 2018 were enrolled in this study. According to self-rating depression scale (SDS) preoperatively, 36 patients were fall in the depression group, while the remaining 90 patients were termed as the non-depression group. The VAS-back, VAS-leng, ODI and JOA scores, as well as postoperative satisfaction level of patient were compared between the two groups, and the correlations between preoperative SDS score and postoperative clinical items was analyzed. [Results] All patients in both groups had operation completed successfully with no significant differences in operation time, blood loss, hospital stay and complications between 2 groups (P＞0.05) . All patients were followed up for more than 2 years. The VAS-back, VAS-leg and ODI scores significantly decreased (P＜0.05) , while JOA scores significantly increased in both groups at 2 years postoperatively compared with those before operation (P＜ 0.05) . The depression group had significantly higher VAS-back, VAS-leg and ODI scores (P＜0.05) , whereas significantly lower JOA score than the non-depression group at 2 years after surgery (P＜0.05) . The patients’ satisfaction rate was of 72.22% (26/36) in the depression group, whereas 88.89% (80/90) in the non-depression group, which was statistically significant (P＜0.05) . As results of correlation analysis, the preoperative SDS was significantly positively correlated with postoperative dissatisfaction level (P＜0.05) , significantly positively corre- lated with postoperative ODI score, VAS-back score and VAS-leg score (P＜0.05) , whereas negatively correlated with postoperative JOA score (P＜0.05) . [Conclusion] Preoperative depression has considerably adverse impacts on postoperative satisfaction and surgical efficacy for LSS.