Since Valls et al. described percutaneous vertebral biopsy in 1948, percutaneous surgical instruments and techniques have been steadily updated. 1986, Schreiber et al. introduced arthroscopy into percutaneous myelomeningocelectomy with an excellent rate of 95%. In 1997, Yeung et al. developed a third-generation percutaneous endoscopic system and used it in clinical practice. The implementation of PELD requires a deep understanding of the anatomy around the fibrous ring, the safety triangle, the subscopic site of the fibrous ring opening, the nerve root foramen and the subscopic appearance of the nerve root, as well as the need to alternate between the endoscope and the operating instruments during the operation, which cannot be done simultaneously under direct vision. The narrow field of view and intervertebral foramen and the steep learning curve of the operation limit its clinical application. Whether compared with traditional open surgery or microdiscectomy and microendoscopic discectomy, PELD has the advantage of being more minimally invasive in the treatment of extreme posterolateral lumbar disc herniation with minimal bleeding; local anesthesia is safe and reliable, and the herniated disc is fully removed by endoscopy and the nerve roots are directly decompressed, and patients can feel improvement in nerve root symptoms immediately after surgery. The use of PELD tissue damage is light, and the patient can leave the bed and discharge the next day after surgery. The indications for PELD depend on the patient’s anatomical limitations of the endoscopic procedure itself, as well as the surgeon’s technical mastery and experience with endoscopic surgery. Contraindications are determined by the surgeon’s experience and skill, but pregnancy, severe spinal degeneration, spinal stenosis, spinal instability, intracanalicular adhesions, and significant free nucleus pulposus tissue are contraindications.