The overall global prevalence of low back pain has been reported to be as high as 31%. Studies have reported that 1.6% to 12% of patients being treated for low back pain have clinical signs of superior cluneal nerve entrapment syndrome. Diagnostic nerve block injections may result in therapeutic relief; however, this relief often is temporary, and many patients require surgical decompression for long-term symptom improvement. This video explains indications, patient positioning, and helpful surgical equipment for the procedure. In addition, a step-by-step surgical approach, postoperative management, and helpful pearls to limit postoperative complications are discussed. A clinical case is reviewed, and results from two different studies performed in the adult population are explained. The results of a retrospective case series in adolescents and young adults is presented.