The open lumbar discectomy with 3D microscope (OLDM) is considered the most common surgical procedure for herniated or ruptured discs of the lumbar spine, while unilateral biportal endoscopic (UBE) technique is a rapidly growing surgical treatment for spinal surgery. UBE as a new endoscopic technique has been applied to conventional arthroscopic systems for treating the spinal disease. In this research, we aimed to evaluate and compare the perioperative parameters and clinical outcomes, including operative time, intraoperative, blood loss, pain and modification, hospital stay, patient's satisfaction, and complications, between OLDM and UBE for lumbar disc herniation. A total of 76 patients with lumbar disc herniation were included in this study from February 2019 to February 2022. All of them had received spinal surgery who underwent OLDM (42 cases) and UBE (34 cases) in Affiliated Hospital of Nantong University and Affiliated Nantong Hospital 3 of Nantong University. Respectively, all the patients had 1 level lumber disc herniation. Perioperative metrics were compared between the 2 groups: estimated blood loss, operation time, length of hospital stay, and complications of the patients. The visual analog scale (VAS) for back and leg pain, and Oswestry Disability Index (ODI) and modified MacNab criteria were tested before surgery and 3 days, 3 months and 12 months following surgery. Compared with the OLDM group, the UBE group had obviously shorter operative time, less intraoperative blood loss, and shorter hospital stay. In addition, the VAS and ODI scores had a significantly reduction in 2 groups after operation. There was no great difference of VAS and ODI scores in preoperative and 3 days, 3 months, and 12 months after operation between the 2 groups. Meanwhile, there was no significant difference in the rate of operational conversion and complications between the 2 groups. Application of OLDM yielded similar clinical outcomes to UBE for treatment of lumbar disc herniation containing pain control and patient satisfaction. Nevertheless, UBE was associated with several advantages relative to OLDM in terms of surgical time, intraoperative blood loss, short-term postoperative pain relief and postoperative hospitalization.