Endplate pathology plays an important role in the development of lumbar disc degeneration. Previous research paid little attention to differences between the superior and inferior endplates as a possible risk factor for disc degeneration. The purpose of this study was to test the hypothesis that asymmetry between the superior and inferior endplates is a risk factor for the development of lumbar disc degeneration. A total of 134 patients with lumbar disc herniation (LDH) and 100 healthy adults (Controls) underwent magnetic resonance imaging scans. Each disc was categorized as non-degenerated (Pfirrmann grades I-II) or degenerated (Pfirrmann grades III-V) and get the following three groups: Degenerated LDH discs (n=145), Non-degenerated LDH discs (n=525) and Non-degenerated Control discs (n=500). On mid-sagittal image, the lumbar endplate morphology could be categorized into three types: Flat, concave, and irregular. Superior and inferior endplates of a given disc were symmetric if both were of the same type, and asymmetric if they were of different types. The proportion of asymmetric endplates at L4-5 was higher in the Degenerated LDH discs group (47%) than in the Non-degenerated LDH discs group (21%) or Non-degenerated Control discs group (7%) (p<0.05). At L5-S1 the proportions were 73%, 55%, and 38% (p<0.05). Asymmetry of superior and inferior endplates in the mid-sagittal plane is a risk factor for lumbar disc degeneration. (c) 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2469-2475, 2018.