[Objective] Clinical effect and imaging analysis of percutaneous endoscopic transpedicular decompression in the treatment of cervical interforaminal stenosis. [Methods] Retrospective analysis was performed on 47 patients with cervical intervertebral foraminal stenosis treated by percutaneous endoscopic transpedicular decompression from June 2021 to June 2022. Visual analog scale (VAS) of cervical pain and cervical dysfunction index (NDI) were used to evaluate the clinical efficacy. The anteroposterior diameter (IFD), anteroposterior diameter (MFD), anteroposterior diameter (DFD), and foraminal height (FH) before and after the operation were compared. [Results]All 47 patients who underwent percutaneous endoscopic posterior pedicle decompression were followed up for more than 6 months, and the VAS score of neck and shoulder, VAS score of upper limb and NDI score of the next day after surgery and the last follow-up after surgery were improved compared with those before surgery, the difference was statistically significant (P<0.05). The anteriorposterior diameter of the inner and middle foramen before and after surgery was statistically significant (P<0.001), but the anteriorposterior diameter of the outer foramen and the height of the foramen were not statistically significant (P> 0.05). [Conclusion] Endoscopic transpedicular decompression has satisfactory clinical efficacy in the treatment of cervical interforaminal stenosis, and it is sufficient to decompress the internal and middle foraminal orifice.