Aim:Lumbar disc herniation is a common disease and can cause back pain and radicular pain. Some cases require surgical intervention for persistent severe pain. In other cases, transforaminal epidural steroid injection is the treatment of choice. This study compared the outcomes of fluoroscopically guided transforaminal epidural steroid injections of L4-L5 paramedian disc herniation with L5-S1 paramedian disc herniation for the treatment of radicular pain.Material and Methods:A total of 593 patients treated by transforaminal epidural steroid injections for the treatment of L4-5 paramedian disc herniation and 504 patients treated by transforaminal epidural steroid injections for the treatment of L5-S1 paramedian disc herniation were included in the study. All the patients were regularly followed up for 12 weeks. Pre-procedutral Visual Analogue Scale (VAS) scores, 12-week post-procedural VAS scores and complications were recorded.Results:For radicular pain, the mean preprocedural and postprocedural VAS scores for L4-5 paramedian disc herniation were 63.09±5.37 and 15.81±3.58, respectively, the mean preprocedural and postprocedural VAS scores for L5-S1paramedian disc herniation were 61.15±5.45 and 27.06±3.62, respectively. There was statistically significant difference between preprocedural and postprocedural VAS scores for L4-5 and L5-S1 paramedian disc herniation, and p values were p<0.05. And transforaminal epidural steroid injections for L4-5 paramedian disc herniation was more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation. Conclusion:This study showed that transforaminal epidural steroid injections for L4-5 paramedian disc herniation was more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation in 12-week follow-up period.