Abstract: To explore the effect of percutaneous transforaminal endoscopy on patients with extreme lateral lumbar disc herniation (LDH), a total of 60 patients with extreme lateral LDH in our hospital were selected. They were grouped according to the random number table method, each with 30 cases. The control group was given routine laminectomy and discectomy, and the study group was given the percutaneous foraminal endoscopic discectomy. The operation status, length of hospital stay, magnetic resonance imaging (MRI) parameters of lumbar spine before and after operation, degree of pain (VAS) score, and lumbar spine function (JOA) score, Lindblon grading of nerve roots, lower limb nerve conduction velocity and the excellent and good rate of curative effect were compared between the two groups. The results showed that the blood loss in the study group was less than that of the control group, and the hospital stay was shorter than that of the control group (P<0.05). Six months after the operation, the waist and leg VAS score of the study group was lower than that of the control group, and the JOA score, lower limb nerve conduction velocity. And the excellent and good rate of curative effect were higher than those of the control group. Lindblon grading of nerve roots and MRI lumbar imaging parameters were better than those of the control group (P<0.05). It shows that the treatment of extreme lateral LDH with percutaneous transforaminal endoscopy can improve MRI lumbar spine imaging parameters, lower limb nerve transmission, relieve the pain degree of lumbar and leg, and improve lumbar spine function, with significant effects.