Objective: To evaluate the clinical efficacy of visual spinal endoscopy in the treatment of intraspinal gas cysts.Methods: Four patients with intraspinal gas cysts and nerve-compression symptoms were selected and treated with minimally invasive visual endoscopic spinal surgery. The gas cysts were exposed and removed during the operation, and the nerve compression was relieved. We recorded the visual analogue scale (VAS) on the first day before surgery, on the first day, at 1 month, and 3 months after surgery; meanwhile, the JOA clinical efficacy scores on the first day before surgery and at 3 months after the operation were recorded, and the efficacy was evaluated.Results: Four patients with intraspinal gas cysts and nerve-compression symptoms received minimally invasive visual endoscopic spinal surgery. The scores on the first day before surgery, on the first day, at 1 month, and 3 months after surgery were (7.6±1.2) points, (3.8±0.3) points, (1.4±0.2) points, and (1.6±0.1) points, respectively. The postoperative scores were significantly lower than those before the surgery, with statistically significant differences (all P<0.05). The JOA clinical efficacy scores on the first day before surgery and at 3 months after the operation were (11.6±1.1) and (25.5±1.9) points, respectively, with an excellent and good rate of 100%, and there was no statistically significant difference (both P>0.05).Conclusion: Visual spinal endoscopy for the treatment of gas cysts in the spinal canals can effectively eliminate or relieve radicular symptoms caused by gas cysts compressing nerves,with the advantages of less trauma, less bleeding, good visual field, high safety and quick postoperative recovery. And it is an effective treatment.