objective: MED combined with PELD treatment of disc herniation of L5S1.Methods: from January 2017 to September 2019, 48 patients with L5S1 disc herniation were selected, and the MED approach was adopted to determine the channel located at the lamina junction of L5S1.Bite off part of the vertebral plate and yellow ligament, the defect in the formation of about 1.0 cm.Put soft tissue expansion 1, level 2 rods in intervertebral disc gap with MED, and then place the PELD in, show the inside of the intervertebral disc tissue and nerve and dural sac, then rotate with casing pipe tip isolates the dural sac and nerve to the inside, and loosening MED channel, make PELD mirror with nerve of the organization, to detect and remove the disk after good exploration nerve activity, ion knife repair annulus fibrosus.Results: following up for 1-33 months, Macnab score was excellent in 33 cases and good in 15 cases.Conclusion: MED combined with PELD for the treatment of L5S1 disc herniation, combined with the advantages of both, can get a good therapeutic effect