The aim of this retrospective study was to compare the short-term (4 weeks) surgical complications after unilateral laminotomy for bilateral decompression (ULBD) in patients with lumbar spinal stenosis, below and above age 65. Twenty-nine consecutive patients operated upon in 2011 were included: 12 below age 65, and 17 above age 65. Five complications (17.1%) were observed, all in the older age group: 3 dural tears, one root injury, and one subcutaneous collection requiring re-operation. The difference between groups was not statistically significant (p = 0.0521). Moreover, comparable or higher complication rates were noted after alternative techniques. The CRP level, obtained one day postoperatively, was lower than after alternative procedures, pleading for the limited invasiveness of ULBD. Old age seems to be associated with slightly elevated rates of short-term surgical complications, but without an increment in morbidity. Unilateral laminotomy for bilateral decompression does not carry an excessive risk in the elderly population.