Objective To evaluate the clinical effect of percutaneous large diameter Fullendoscopic interlaminar approach in the treatment of lumbar spinal stenosis.Methods 46 patients of lumbar spinal stenosis admitted to AVIV 363 hospital from January 2016 to May 2018 with single level stenosis were involved in the present study. Types of stenosis included lateral spinal canal stenosis, central canal stenosis, and mixed stenosis. According to the type of stenosis, the central canal stenosis was decompressed by percutaneous full-endoscopic laminar fenestration, the lateral spinal canal stenosis and mixed stenosis were decompressed by percutaneous fullendoscopic Laminar fenestration and nerve root canal decompression. Partial excision of nucleus pulposus was performed with herniation of intervertebral disc and bilateral decompression via unilateral approach for bilateral stenosis.using the VAS of low back pain and leg pain, Oswestry disability index and a modified Macnab’s criterion evaluate the shortterm outcome. Results 46 cases successfully completed surgery. The operative time was (92.25±19.63) min, intraoperative bleeding volume (15.52±6.78) ml, hospitalization time 5.10 days (mean 6.6 days). All patients were followed up for 12-18 months (mean 14 months). The VAS score of low back pain was (5.55±0.83) score before operation, (2.65±0.75) score immediately after operation, (2.35±0.67) score at 3 months after operation, (2.20±0.52) score at 6 months after operation and (2.05±0.39)score at last follow-up. The VAS score of leg pain was (565±113) score before operation, (2.45±0.98) score immediately after operation, (2.35±0.87) score at 3 months after operation, (2.15±0.67) score at 6 months after operation and (2.05±0.51) score at last follow-up after operation. There was a significant difference between preoperative and postoperative VAS scores (P＜0.05).The ODI scores were (73.15±9.92)% in preoperative, (2920±781)% in immediate postoperation, (25.55±5.01)% in 3 months after operation , (20.90±4.76)% in 6 months after operation and (18.85±5.33)% in the last follow-up. Improved macnab was used to evaluate the curative effect. There were excellent in 35 cases, good in 7 cases, fair in 3 cases, poor in 1 case. The excellent and good rate was 91.3%.Conclusion Percutaneous large diameter endoscopy is a safe and effective minimally invasive operation for lumbar spinal stenosis.