We investigated the clinical relationships between lumbar spinal stenosis (LSS) and atherosclerotic risk factors (ASRF) such as diabetes mellitus (DM), hypercholesterolemia (HC), hypertension (HT) and atherosclerotic vascular disease (ASVD) as well as the effects of these diseases to the results of conservative treatment. Presence of ASRF and ASVD, complaints of pain and neurogenic claudication (NC) were identified and physical inspection including walking distances, lumbar area inspection, vascular inspection were performed. Radiological and laboratory tests were evaluated. Physical therapy were applied to all 38 patients. Walking distances were shorter and neurogenic complaints were higher in patients with ASVD before treatment (p<0.05). After treatment, walking distances were found to be shorter in patients with HT and ASVD and complaints of NC was higher in patients with ASVD (p< 0.05). No difference regarding intensity of pain occurred. There was no significant difference between patients with HC and DM, and patients without these diseases regarding evaluations before and after treatment (p>0.05). As a result, we can say that co existence of HT and ASVD in patients with LSS have negative effects on response to conservative therapy. HC and DM have indirect effects due to the risks for ASVD. One should consider the treatmeat of ASRF in patients with LSS.