Abstract: Objective To investigate the perioperative characteristics between minimally invasive transforaminal lumber interbody fusion (MIS-TILF) and posterior lumber interbody fusion (PLIF) in the treatment of single-level lumbar degenerative disease in patients older than 75 years. Methods Clinical data about 45 cases older than 75 years with single-level lumbar degenerative disease who underwent lumber operation from June 2010 to June 2013 were retrospectively analyzed, including 20 cases underwent direct vision MIS-TILF, and 25 cases underwent traditional open PLIF. Comorbidities were investigated before surgery, and the perioperative characteristics were compared between the two groups. Results There were no significant differences in gender, age, lesion location and comorbidities (P> 0.05). The mean age of patients in MIS-TLIF group was 77.2±2.0 years while it was 77.8±1.9 years in PLIF group. There were 1 complication with an incidence of 5% in MIS-TILF group and 5 complications with an incidence of 20% in PILF group but no significant difference was found between two groups (P> 0.05). There were less blood loss, ambulation time and hospitalization time in MIS-TLIF group than in PLIF group (P< 0.01). The back pain VAS of MIS-TLIF group at 3 days postoperative were better than that in PLIF group (P< 0.05). No significant differences were observed in postoperative leg pain VAS and ODI scores between the two groups (P> 0.05). Conclusion Compared with PLIF, MIS-TLIF has advantages of less trauma and quick recovery in patients older than 75 years with single-level lumbar degenerative disease.