Abstract:[Objective] To explore the safety and efficiency of TESSYS-ISEE technique of percutaneous endoscopic lumbar decompression for Lumbar lateral recess stenosis in the geriatric patients；[Methods] A retrospective study was conducted on 29 geriatric patients who underwent TESSYS-ISEE in percutaneous endoscopic lumbar decompression for lumbar lateral recess stenosis from January 2017 to May 2018 in our institution.The clinical effectiveness were evaluated with Visual Analogue Scale (VAS)score and Oswestry Disability Index (ODI).The modified MacNab’s criteria were used to evaluate the excellent and good rate at the lastest follow-up after operation. [Results] All cases received successful surgical procedures.Only 1 case with dural tear,no neurovascular injury ,intervertebral infection and symptomatic residual disc herniations were founded in all cases. The operation time was 55~95min,（72.29±11.52) min，postoperative hospital stay from 2 to 6 d,(3.75±1.04)d ; 29 cases were followed up for 13~25 months,（18.76±3.92）months.During follow-up,1 case experienced the recurrent of lumbar disc herniation .The postoperative VAS scores of low back pain and leg pain , ODI scores improved significantly as compared with that before operation（P＜0.05）.Base on Modified MacNab’s criteria,the excellent and good rate was 89.66% at the latest follow-up.[Conclusion] The TESSYS-ISEE technique of percutaneous endoscopic lumbar decompression to be an safe and efficacious management in the geriatric patients with lumbar lateral recess stenosis .It is worthy of promotion .