[Objective] To analyze the effect of Traditional Chinese Medicine Governor?Vessel?combine with endoscop for treating senile lumbar spinal stenosis. [Methods] From January 2021 to December 2021, 45 patients of minimally invasive decompression under spinal endoscopy. According to the results of preoperative doctor-patient communication, There were 22 cases treated by Traditional Chinese Medicine Governor?Vessel?combine with endoscop, and 23 cases treated by endoscop. Comparison of perioperative, follow-up and imaging data between the two groups. [Results] Both groups successfully completed the operation. There was no significant difference between the two groups in operation time, incision length, intraoperative fluoroscopy times, intraoperative blood loss, landing time and hospitalization time (P>0.05). In the combined group, one patient suffered from transient sensory impairment due to injury to the walking nerve root, and one patient suffered from postoperative muscle strength decline due to dural sac avulsion. After 3 months of treatment with nutritional nerve and traditional Chinese medicine, they gradually recovered to normal. Both groups of patients were followed up for more than 12 months. The scores of TCM syndromes, VAS low back pain and leg pain scores, and ODI dysfunction index of the two groups were significantly improved compared with those before the operation, with a statistically significant difference (P<0.05). At the last follow-up after the operation, the scores of the combined group were better than those of the simple group, with a statistically significant difference (P<0.05). At the last follow-up after the operation, the scores of the combined group were better than those of the simple group, The difference was statistically significant (P<0.05). During the follow-up period, there was 1 case of recurrence of intervertebral disc herniation in the simple group, and the rest did not have late complications such as recurrence and spondylolisthesis. In terms of imaging, there was no statistically significant difference in the height of intervertebral space, lumbar lordosis angle and spinal canal area between the two groups at the same time point (P>0.05), and there was no statistically significant difference in the height of intervertebral space and lumbar lordosis angle between the two groups at the same time point (P>0.05), but the spinal canal area at the last follow-up after surgery was significantly larger than that before surgery, with a statistically significant difference (P<0.05). [Conclusion] Traditional Chinese Medicine Governor?Vessel?combine with endoscop can relieve nerve compression and dredge the blood stasis of the governor vessel, significantly improve nerve function and promote rapid recovery.