Abstract Objective: Transforaminal epidural steroid injection is the most used intervention as minimally invasive non-surgical management of lumbar radiculopathy. While fluoroscopy guidance remains the traditional gold standard, ultrasound guidance has also gained popularity. This study compares the efficacy, safety, and radiation exposure of ultrasound-guided versus fluoroscopy-guided TFESI. Study Design: Prospective, Single Blind, Randomized Controlled Trial.