Objective: This study was designed to evaluate the efficacy of surgical decompression in treatment of meralgia paresthetica. Patients and Methods: This study included 30 patients (18 females, 12 males) within age range of 24-62 years presented with meralgia paresthetica with mean duration of symptoms 29.3±5.4 months. All the patients were subjected to conservative management for 6 months. 12 patients were not improved with conservative treatment .9 patients (70%) underwent unilateral neurolysis of the lateral femoral cutaneous nerve (LFCN), whereas 3 patients (25%) underwent bilateral neurolysis of the LFCN. Surgical outcome was graded subjectively by each patient postoperatively based on 0-5 pain intensity scale. Results: The mean follow-up period was 14 months; range: 6-24 months. Surgical outcome was graded subjectively by each patient postoperatively based on 0-5 pain intensity scale; 5 patients (41.7%) improved completely; 2 patients (16.7%) significant improved; 1 patient (8.3%) temporary improved; 4 patients (33.3%) not improved, (Table 7). For the 4 (33.3%) patients who did not improve after surgical decompression, re-exploration with trans-section of the LFCN was done (1case bilateral, 3 unilateral) & pain improved completely in all patients. Conclusion: It could be concluded that neurolysis of the LFCN is an effective treatment for meralgia paresthetica in properly selected patients & trans-section of the LFCN is indicated for patients who did not improved after surgical decompression. Keywords: Neurolysis, lateral femoral cutaneous nerve, meralgia paresthetica.