Minimally invasive treatment of lumbar disc herniation is a good concept and has been rapidly developed and accepted by patients in recent years. However, due to the indications, some patients who are not suitable for minimally invasive surgery have minimally invasive surgery, and the results of this part of patients are to be discounted. The best indications for minimally invasive treatment of lumbar disc herniation should be patients with lateral or extreme lateral disc herniation, without spinal stenosis or intervertebral space narrowing and lumbar instability. Other types of patients can also be done, but it is difficult to solve all the discomfort of the patient. Recently, we performed a case of extreme posterolateral disc herniation. The patient had numbness in the left lower extremity for more than a year, and various conservative methods did not work well. From the film, the herniation was not large, but the location was in the left neural foramen. We performed foraminoscopic surgery on the patient, and the numbness disappeared immediately after surgery, and the patient reported that the preoperative symptoms were basically 100% relieved. The advantages of this technique are obvious: less pain for the patient, smaller incisions, and better recovery, but the key point is to make sure that the indications are good and to select the right patient for the right procedure. MRI shows a bulging disc in the left intervertebral foramen Intraoperative positioning fluoroscopy Removed disc nucleus pulposus tissue patient’s incision