Purpose: This study aimed to explore the experiences and pivotal influencing factors of patients with Lumbar disc herniation (LDH) during the surgical decision-making phase to provide a basis for optimizing the shared decision-making between medical professionals and patients and for the implementation of personalized nursing care. Patients and Methods: This phenomenological study employed face-to-face semi-structured interviews, conducted between January and February 2025. Purposive sampling method was used to select 20 patients with lumbar disc herniation from the orthopedic ward of a tertiary hospital. The interview data were analyzed by Colaizzi's seven-step phenomenological analysis method. Results: The findings of this study revealed that the surgical decision-making experiences of patients with LDH can be delineated into four themes: (1) Motivations underlying the surgical Decision; (2) Decision-making dilemmas arising from insufficient patient information; (3) The multi-dimensional factors influencing decision-making, and (4) Patients express unmet peri-operative needs. Conclusion: This study reveals that surgical decision-making in patients with lumbar disc herniation is a complex process involving the interaction of biological, psychological, and social factors. It is essential to establish a patient-centered decision-support system, integrating structured information tools, psychological interventions, and hierarchical educational strategies. Future research endeavors should concentrate on the potential value of digital health technologies in enhancing the decision-making experience and seek to augment the effectiveness of decision-making aids through cultural adaptation.