A study aims to investigate the relationship between serum miR-204 and clinical features of patients with lumbar disc herniation (LDH). Clinical data of 1589 LDH patients were retrospectively analyzed. There were 953 patients (group A) with a duration of disease shorter than 3 months, and another 636 patients (group B) with a duration of disease longer than 3 months. A total of 300 healthy volunteers were also selected in the same period. Results showed that there was no significant difference in miR-204 expression between males and females (p>0.05). No significant differences in miR-204 expression level were found among different ages (p>0.05). miR-204 in patients with LHD at or below the fourth lumbar vertebrae was significantly higher than those in patients with LHD above the fourth lumbar vertebrae (p<0.05). miR-204 in 1485 patients with abnormal lumbar spine activity was higher than those in healthy controls (p<0.05). miR-204 expression levels was higher in patients with low back pain than those in patients without low back pain. Among patients with low back pain, miR-204 level in patients with spasm-like waist pain was significantly higher than that in patients with persistent dull low back pain (p<0.05). miR-204 increased with the increase in degree of limited walking (p<0.05). There was no significant difference in miR-204 expression level between patients with bilateral lower limb symptoms and patients with unilateral lower limb symptoms (p>0.05), while miR-204 was significantly higher in patients with lower limb symptoms than that in patients without the symptoms (p<0.05). miR-204 was correlated with knee tendon reflex, heel tendon reflex and degree of straight leg raise abnormality. miR-204 was significantly decreased in patients with improvement after treatment. miR-204 level was closely related to the clinical characteristics of LDH. miR-204 may potentially serve as a prognostic marker for patients with LDH 1).