Surgery for meralgia paresthetica is considered only when symptoms are severe, persistent, and unresponsive to conservative treatments such as lifestyle changes, medications, or corticosteroid injections. The goal of surgery is to relieve pressure on the lateral femoral cutaneous nerve, most commonly through nerve decompression or, less commonly, neurectomy (cutting the nerve). Decompression aims to preserve sensation, while neurectomy may relieve pain but results in permanent numbness in the outer thigh. Surgical outcomes are generally favorable for pain relief, though results vary and numbness may persist. As with any surgery, risks include infection, scarring, or incomplete symptom resolution.