Purpose <p>This study summarizes clinical data on daytime percutaneous endoscopic treatment for lumbar disc herniation and lumbar spinal stenosis, comparing outcomes with those of matched hospitalized patients, aiming to analyze its clinical efficacy and identify associated challenges.</p> Methods <p>Retrieve clinical data from the shared database of orthopedic cases, which contains a total of 5,793 cases. Among them, 2,592 cases involve lumbar spine diseases, with some of these patients having undergone daytime percutaneous endoscopic surgery for LDH or LSS by the same team. Match these with hospitalized patients at a 1:2 ratio. A total of 478 patients were recruited, of which 164 underwent daytime surgery and 314 underwent inpatient surgery. All patients were followed with 2 years; a set of clinical outcomes were extracted and analyzed.</p> Results <p>Compared to the inpatient surgery group, the day surgery group demonstrated significantly reduced hospitalization duration and costs (<i>P</i> &lt; 0.05). However, the incidence of worsened symptoms after discharge was significantly lower in the PEID-A group compared to the PEID-D group (<i>P</i> &lt; 0.05). Compared to hospitalized surgical patients, there is no significant difference in the recurrence rate among day surgery patients (<i>P</i> &gt; 0.05).</p> Conclusion <p>The therapeutic effect of percutaneous endoscopic treatment for lumbar spine diseases performed as day surgery is satisfactory. While offering advantages such as lower costs and shorter hospital stays, daytime percutaneous endoscopic surgery requires enhanced preoperative preparation, postoperative medication, patient guidance, and rehabilitation.</p>