Objective To explore the application value of individualized preoperative design combined with localization puncture guide in beginner of percutaneous endoscopic lumbar discectomy.Methods 32 patients with disc herniation who underwent percutaneous endoscopic lumbar discectomy of posterior lateral appropach from October 2019 to April 2020. The same beginner completes the positioning puncture step according to the corresponding method of the regular group and the experimental group. Compare the fluoroscopy times and the puncture needle adjustment times required for successful puncture between the two groups.Results The median and extreme values of the fluoroscopy frequency of the routine group and the experimental group were 23.50 (14～32) times, 10.00 (8～14) times, and the puncture needle adjustment times were 5.50 (2～13) times, 1.00 (0 ~ 2) times (P < 0.05).Conclusion For beginners of percutaneous endoscopic lumbar discectomy, the application of individual preoperative design combined with positioning puncture guide can reduce the number of fluoroscopy and improve the accuracy of puncture.