Central lumbar disc herniation refers to the protrusion of the nucleus pulposus from the posterior central part of the disc. The nucleus pulposus and fragments of the annulus fibrosus gather under the posterior longitudinal ligament or enter the spinal canal to stimulate or compress the cauda equina nerve and cause clinical symptoms. The incidence of central lumbar disc herniation is generally 10-15%, with the majority of herniated sites being lumbar 4 and 5. The duration of clinical manifestations varies. Most cases have recurrent episodes of lumbar pain and sudden aggravation at the end. Some of them have sudden onset after sprain or exertion. Most patients have low back pain and radiating pain of both lower limbs. However, the pain varies in severity. If the protrusion is large, it may manifest as incomplete paralysis of both lower limbs, perineal sensory changes and bowel and urinary dysfunction. The physiological anterior convexity of the lumbar spine disappears. There is pressure pain and percussion pain between the spinous processes of the involved planes. Nociception in the saddle area is reduced or absent, and sensory, motor and reflex changes in both lower extremities are seen to varying degrees. CT scan and MRI are of great value in central disc herniation, showing the site of involvement, the size of the herniation and the degree of compression of the cauda equina. Central lumbar disc herniation is mainly treated surgically. Surgical removal of the herniated material is possible via epidural or transdural removal with half or full laminectomy. Intraoperative care should be taken to avoid nerve injury.