Most patients with lumbar disc herniation can achieve good results through non-surgical treatment, and only a fraction of them need surgical treatment. For this part of patients, timely surgery can also relieve pain and restore labor force. The indications for surgery in patients with lumbar disc herniation are: patients with severe symptoms that affect work life and are ineffective with non-surgical treatment; or patients with severe symptoms and pain that cannot receive non-surgical treatment; patients with extensive muscle paralysis, hypesthesia and damage to the cauda equina, complete or partial paralysis; patients with severe intermittent claudication, mostly with spinal stenosis at the same time, or patients with spinal stenosis shown on X-ray plain film and CT images; patients with combined lumbar isthmus and spinal stenosis; and patients with spinal stenosis. For those who have stenosis; for those who have combined lumbar isthmus discontinuity and spinal slippage, surgical removal of the diseased nucleus pulposus and simultaneous fusion of the contralateral vertebral plate and interspinous bone graft are recommended; for young and middle-aged patients with recurrent episodes, the indications for surgery can be relaxed in order to restore work capacity. The indications for surgery should be strictly controlled for elderly and frail patients. Lumbar disc herniation is a field where minimally invasive spinal techniques are widely used and mature, and should be selected according to the patient’s own condition, the surgeon’s experience and the hospital’s specific situation. In general, patients with mild symptoms, early stage of the lesion, MRI or CT examination suggesting mild herniation of the lumbar disc, no nucleus pulposus breaking through the fibrous ring, no free and prolapsed disc fragments, and no significant segmental instability present can be treated with percutaneous intervention. For patients with more severe symptoms and advanced lesions, MRI or CT examinations suggesting severe lumbar disc herniation, rupture of the fibrous annulus, prolapsed or free nucleus pulposus, disc calcification, significant bone growth, significant ligamentous hypertrophy, narrowing of the spinal canal and lateral saphenous fossa, and significant instability, microscopic or endoscopic posterior lumbar decompression or small incisional disc removal with the assistance of minimally invasive instruments are required. For patients with lumbar disc herniation combined with lumbar instability, minimally invasive disc removal, interbody fusion and percutaneous internal fixation can be considered.