Abstract: Objective To investigate the short-term effect of percutaneous transforaminal endoscopic discectomy versus small-incision interlaminar fenestration for lumbar disc herniation(LDH)in the elderly. Methods The clinical data of 88 elderly patients with LDH who were treated in the spinal surgery department of our hospital was analyzed retrospectively. According to the different surgical methods, they were divided into two groups. A total of 53 patients treated with percutaneous transforaminal endoscopic discectomy were selected as endoscopic group, another 35 patients treated with traditional small-incision interlaminar fenestration were included in small incision group. The operation related indexes, hospitalization time and complications were compared between the two groups. The improvement condition of lumbar function after 3 months of operation in the two groups was compared. Results The bleeding volume and incision length were less and shorter, Visual Analogue Scale(VAS)score at 1 week after operation was lower, and hospitalization time of the endoscopic group was significantly lower than those of the small incision group(P< 0.05). The incidence of surgical complications was significantly lower than that of the small incision group(5.66% vs. 25.71%, P<0.05). The scores of Oswestry dysfunction index(ODI)and Japanese Orthopedic Association(JOA)scores at 3 months after operation in the two groups were significantly improved(P<0.05), and the endoscopic group had significantly lower ODI, and significantly higher JOA scores - than that in the small incision group(P<0.05). Conclusion Percutaneous transforaminal endoscopic discectomy has less trauma and complications, and better recovery of postoperative lumbar function in the treatment of LDH in the elderly versus small-incision interlaminar fenestration.