Acute cauda equina syndrome is a common and serious disorder of the cauda equina caused by lumbar spine pathology, which can lead to sensory-motor deficits in the cauda equina innervation area, including rectal and bladder sphincter deficits, perineal and saddle area sensory deficits. The disabling rate is very high. A patient from Liaoning Liu**, male, 55 years old, admitted to the hospital with the main cause: intermittent lumbar with left lower extremity pain for 10 years, aggravated with bilateral lower extremity pain and numbness for half a month, poor urination and defecation for 7 days, after admission, the patient had persistent pain in both lower extremities, indwelling catheter, could not lie down, could only curl up and kneel on the hospital bed, could not sleep normally for the past half a month, painful, could not even cooperate with the lumbar MRI examination The patient could not even cooperate with the MRI examination of the lumbar spine, which made further treatment very difficult. The operation went smoothly, and the pain in both lower limbs basically disappeared after the operation, and the patient was able to move on the ground with the support of his family. Lateral intervertebral foraminoscopy is an internationally advanced minimally invasive spinal disc technology. Since the second half of 2010, our department has introduced German imported lumbar foraminoscopic equipment and successfully carried out nearly two hundred cases of lumbar disc removal surgery under foraminoscopy with satisfactory results and accumulated rich operating experience, becoming one of the first hospitals in China to master this technology. The successful operation of this patient brings more experience for our next work, and also increases our confidence to better use the foraminoscopic technology to serve the majority of patients.