[Objective] To analyze the safety and effectiveness of lumbar nucleus pulposus enucleation by intervertebral laminar approach (PEID) or foraminal approach (PETD) in patients with giant lumbar disc herniation.[Methods] A retrospective analysis was conducted on 159 patients with giant lumbar disc herniation who underwent endoscopic lumbar nucleus pulpectomy from September 2016 to September 2019 in the orthopedics department of our hospital, including 84 patients in the PEID group and 75 patients in the PETD group.[Result] The perioperative indexes of the two groups were slightly different (P > 0.05); at the last follow-up, the follow-up indexes of the two groups were significantly improved (P < 0.05), while the difference between the two groups was smaller (P > 0.05).[Conclusion] Both foraminal approach and interlaminar approach for lumbar nucleus pulposus enucleation can achieve better clinical efficacy in patients with giant lumbar disc herniation. The approach should be flexibly selected after evaluating the indications of surgery in order to obtain the best results.