Director of pain relief unit (Medical Research Institute,Alexandria University, Egypt) Fellow of Interventional Pain Practice-Texas-USA Postgraduate Certificate of Pain Management-Cardiff University, UK Annotation. <...> Epidural fibrosis has been implicated in persistent pain after back surgery. <...> Epiduroplasty is assumed for targeted epidural medication delivery nearby the desired nerve root may result in better pain relief. <...> The primary goal of the current study was to evaluate the efficacy of fluorouscopic guided epiduroplasty with and without epiduroscopy (EDS) in failed back surgery syndrome (FBSS). <...> FBSS patients were allocated randomly into two groups; the Non-EDS group in whom patients underwent caudal epiduroplasty by flurouscopic guided insertion of Racz catheter and the EDS group in whom patients underwent caudal epiduroplasty by flurouscopic guided insertion of Racz catheter assisted with EDS. <...> Pain severity was measured by visual analogue score for chronic radicular leg pain and functional activities were assessed using Waddell and Main score with a followup to 6 months whereas, satisfaction was observed at 3 and 6 months. <...> There was significant reduction in leg pain score (P < 0.001) at 1, 3, and 6 months when compared to the pre-procedure baseline values in both groups. <...> Also there was significant reduction in leg pain score in EDS group (P < 0.001) at 3 and 6 months compared to the Non-EDS group. <...> The function abilities and satisfaction scores showed statistical significant improvement (P < 0.001) at 3 and 6 months in both groups. <...> No complications recorded and side effects were minimal. <...> Epiduroplasty by fluorouscopic guided insertion of Racz catheter with or without epiduroscopy assistance reduce mono-segmental unilateral radicular leg pain, improve patient functional abilities and satisfaction but with more long term leg pain and functional abilities improvement in epiduroscopic assisted patients, with minimal side effects in FBSS patients. <...> INTRODUCTION The painful symptoms in “failed back surgery syndrome” (FBSS) following surgical spinal procedures reflect a combination of pathological processes, such as interruption of blood flow, venous congestion, ischemia, axonal damage and intraneural fibrosis [1; 2]. <...> Epiduroplasty (adhesiolysis) was tried by numerous modalities <...>