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We admitted a unique case of right lumbar disc herniation at L4L5 who presented with contralateral symptoms and was successfully treated with a right large L4/L5 fenestration and microdiscectomy. When the operation is considered, intervention only from the herniation side is sufficient. In the case presented, it is probable that Kernohan notch?like phenomenon, venous engorgement and congestion at the contralateral side of the herniated lumbar disc and the contralateral migrated epidural fat are responsible for the emergence of contralateral symptoms.