Purpose <p>This study aims to analyze the risk factors and treatment results in pediatric patients undergoing surgery for lumbosacral disc herniation (LDH), with a particular focus on the potential impact of the lockdown associated with the COVID-19 pandemic.</p> Methods <p>A retrospective review of pediatric patients who underwent surgical treatment for LDH between 2011 and 2024 was conducted.</p> Results <p>A total of 30 patients were included in our analysis, with a median age of 16&#xa0;years (range 12–17&#xa0;years). Sports participation (30.0%), obesity (16.7%), and a history of trauma (10.0%) were common risk factors. Each patient presented with radicular pain, frequently accompanied by back pain (73.3%), and sensory changes (43.3%). All patients underwent microdiscectomy (MD), primarily via a fenestration approach (93.3%). Recurrent LDH occurred in 13.3% of cases, requiring reoperation. At a median follow-up of 2.9&#xa0;years, initial postoperative clinical improvement was sustained in 96.7% of the cohort, although recurrent back pain persisted in 33.3% and intermittent radicular pain in 20.0%. Following the lockdown associated with the COVID-19 pandemic, the incidence of LDH qualified for neurosurgical intervention increased 3.3-fold (<i>p</i> = 0.002), while the median length of hospital stay decreased (7 vs 5&#xa0;days; <i>p</i> = 0.005).</p> Conclusions <p>The analysis substantiated that MD is a safe and effective treatment option for children with symptomatic LDH unresponsive to conservative management. The observed increase in incidence of LDH qualified for neurosurgical intervention following the lockdown associated with the COVID-19 pandemic, without the difference in postoperative outcomes, may suggest a potential influence of pandemic-related lifestyle changes.</p>