Objective:To investigate the efficacy and safety of unilateral biportal endoscopic(UBE)in the treatment of elderly patients with lumbar disc herniation(LDH)and degenerative scoliosis.Methods:90 elderly patients with LDH complicated with degen-erative scoliosis were selected,and they were divided into UBE group(n=45)and open group(n=45)according to different inter-vention methods.The indexes related to surgery and hospitalization,the Japanese Orthopaedic Association(JOA)lumbar function score,Oswestry Disability Index(ODI),intervertebral height,spinal canal area,lumbar scoliosis Cobb Angle,and visual analog score(VAS)were compared between the two groups.The incidence of complications during hospitalization was recorded and compared be-tween the two groups.Results:The intraoperative blood loss in UBE group was lower than that in open group(P＜0.05),and the first time of getting out of bed and the length of hospital stay were shorter than that in open group(P＜0.05).The operative time of UBE group was longer than that of open group(P＜0.05).3 months after surgery,there were no significant differences in JOA lumbar func-tion score,ODI,intervertebral height,vertebral canal area and Cobb Angle between the two groups(P＞0.05).The VAS scores in the UBE group were lower than those in the open group at 1 day and 3 months after surgery(P＜0.05).During hospitalization,the compli-cation rate in the UBE group was lower than that in the open group(P＜0.05).Conclusion:The efficacy of UBE in the treatment of elderly LDH complicated with degenerative scoliosis is comparable to that of traditional open surgery,but UBE is beneficial to reduce in-traoperative blood loss,relieve pain,promote postoperative recovery of patients,and reduce the risk of postoperative complications,but the operation time is relatively prolonged.