Abstract: [Objective] To evaluate the safety and effectiveness of visualized trephine in percutaneous endoscopic intervertebral foramen approach. [Methods] From May 2017 to June 2018, 58 patients were divided equally into two groups，visualized triphe group and TESSYS group , and underwent percutaneous endoscopic discectomy through intervertebral foramen approach. In visualized triphe group was punctured to the outside of the upper articular process and established a working channel, and articular process was visually formed. TESSYS group followed the classic TESSYS procedure. Age, gender, number of fluoroscopy, foraminoplasty time and complications of the two groups were counted, and the visual analogue scale (VAS), and MacNab standard were used to evaluate the clinical efficacy before, after and at the last follow-up. [Results] All patients completed the operation, and none changed to open surgery. There was no significant difference in gender and age between the two groups (P>0.05). VAS score, ODI and JOA score were compared before, after operation and at the post-operation 12 month follow-up between the two groups, there were significantly improvements in all the three kind of scores after surgery with statistical difference (P＜0.05), while there was no statistically significant difference between the two groups (P>0.05). MacNab criteria, Visualized triphe group and TESSYS group were 89.66%、86.21% respectively , comparing the two groups have no statistical difference (P > 0.05). Time of foraminoplasty and number of fluoroscopy are 12.33±9.86minutes , 4.52±2.64 times, respectively, in visualized triphe group. In TESSYS group are 20.54±10.46 minutes and 15.26 ±4.51 times. Compared with the two groups, the difference of foraminoplasty time and number of fluoroscopy were statistically significant (P＜0.05). There were no complications such as bleeding and infection in the two groups. In TESSYS group, there were five cases of second foraminoplasty， one case of injury of exit never root, three cases of ambulatory root membrane injury, no neurological complications and one had symptomatic facet bone residue and was treated with open surgery. [Conclusion] Compared with the classic TESSYS technique, the application of visualized trephine has the advantages of simple puncture, less radiation exposure, surgical effect reliable. Visualized trephine is an effective and safe technology.