The paper reviews the advancements and challenges in endoscopic spine surgery, a minimally invasive technique that has evolved over several decades. Endoscopic spine surgery can be applied to all levels of the spine and has shown promising clinical outcomes, supported by robust trials. Despite its cost-effectiveness and positive societal impact, challenges such as anatomical limitations and the need for specialized training persist. Technological advancements, including improved endoscope systems and navigation techniques, are enhancing the field. The paper discusses various endoscopic approaches, including transforaminal, interlaminar, cervical, thoracic, and lumbar interbody fusion techniques. These techniques have demonstrated better clinical outcomes, reduced complications, and shorter hospital stays compared to traditional open surgeries. However, the learning curve for surgeons and the need for specialized training remain significant hurdles. The paper also highlights the potential of endoscopic spine surgery in treating spinal infections and neoplasms, although more research is needed. Overall, the authors conclude that while endoscopic spine surgery faces challenges, ongoing technological advancements and improved surgeon education will drive its continued growth and adoption.The paper reviews the advancements and challenges in endoscopic spine surgery, a minimally invasive technique that has evolved over several decades. Endoscopic spine surgery can be applied to all levels of the spine and has shown promising clinical outcomes, supported by robust trials. Despite its cost-effectiveness and positive societal impact, challenges such as anatomical limitations and the need for specialized training persist. Technological advancements, including improved endoscope systems and navigation techniques, are enhancing the field. The paper discusses various endoscopic approaches, including transforaminal, interlaminar, cervical, thoracic, and lumbar interbody fusion techniques. These techniques have demonstrated better clinical outcomes, reduced complications, and shorter hospital stays compared to traditional open surgeries. However, the learning curve for surgeons and the need for specialized training remain significant hurdles. The paper also highlights the potential of endoscopic spine surgery in treating spinal infections and neoplasms, although more research is needed. Overall, the authors conclude that while endoscopic spine surgery faces challenges, ongoing technological advancements and improved surgeon education will drive its continued growth and adoption.