Abstract: Background: Lumbar herniated nucleus pulposus (HNP) is a major contributor to low back pain and radiculopathy, significantly impairing quality of life. Spinal endoscopy has gained traction as a minimally invasive surgical modality offering effective pain reduction with reduced tissue trauma and recovery time. This study aims to compare Visual Analog Scale (VAS) pain scores before and after spinal endoscopy and to explore associations with clinical factors.