BACKGROUND: This study aims to systematically review and conduct a meta-analysis to assess the clinical outcomes and complications associated with the one-hole split endoscopy (OSE) and unilateral biportal endoscopy (UBE) in the treatment of lumbar degenerative disease, thereby offering a reference for clinical decision-making. METHODS: A comprehensive literature search was conducted utilizing databases such as PubMed, Embase, Web of Science, Cochrane Database, China National Knowledge Network, Wanfang Database, and China Biomedical Literature Database, in conjunction with specific search terms. The retrieved literature was subsequently screened according to stringent inclusion and exclusion criteria. Systematic reviews and meta-analyses were performed using Stata 15.1 software. RESULTS: A total of 513 patients were included across five studies, comprising 246 patients in the OSE group and 267 patients in the UBE group. The findings of this meta-analysis indicated that the incision length in the OSE group was significantly shorter than that in the UBE group (SMD = - 1.92, 95%CI: -3.03 to -0.80, P = 0.001). However, no statistically significant differences were observed between the two groups regarding operative duration, intraoperative blood loss, length of hospital stay, Visual Analog Scale (VAS) scores at various postoperative time points, Oswestry Disability Index (ODI) values at various postoperative time points, rates of excellent and good outcomes, sagittal translation (ST), range of motion (ROM), and complication rates. CONCLUSIONS: Both OSE and UBE techniques are considered safe and effective for the management of LDD, demonstrating comparable treatment outcomes. However, OSE techniques offer the advantages of smaller surgical incisions and potentially reduced trauma.