Twelve randomized controlled trials including 1490 patients with lumbar disc herniation were included in this meta-analysis comparing percutaneous transforaminal endoscopic discectomy (PTED) versus microendoscopic discectomy (MED), percutaneous endoscopic interlaminar discectomy (PEID), or open discectomy (OD). Pooled outcomes of interest included surgery duration, visual analog scale (VAS) for pain, Oswestry Disability Index (ODI), complication rates, and length of hospital stay. PTED showed no significant differences in surgery duration, pain, or disability outcomes compared with MED and PEID at most time points, though back pain was lower after 2 years with PTED compared to MED. PTED was associated with fewer complications and shorter hospital stays compared with OD. Overall, PTED appears comparable to other minimally invasive approaches and superior to open discectomy in terms of safety and recovery.