Thoracic disc herniation (TDH) surgery is particularly challenging due to its technical complexity and the potential for serious complications. The primary objective is to achieve sufficient decompression without compressing the spinal cord while also preventing injury to the paraspinal muscles and facet joints. Posterolateral approach for treating TDH provides an angled perspective of the disc space, helping to prevent damage to the thoracic viscera. However, traditional posterolateral approach often requires extensive muscle dissection along with the removal of ribs and facet joints. Recently, the unilateral biportal endoscopy (UBE) technique for TDH using a posterolateral approach has emerged as an effective method for achieving decompression. It minimizes muscle damage, preserves ribs, and requires minimal spinal cord manipulation, offering technical advantages and a low risk of complications and destabilization. This chapter details the technical implementation of UBE through the posterolateral approach for TDH patients and provides specific surgical recommendations to prevent complications.