Abstract: Objective To compare the clinical outcomes of minimally invasive transforaminal lumbar fusion (MIS-TLIF) and open surgery for massive lumbar disc herniation and evaluate the safety and effectiveness of MIS-TLIF． Methods Clinical data about 59 patients who suffered from single-level massive lumbar disc herniation were investigated from August 2012 to June 2014． Twentyeight cases underwent posterior lumbar interbody fusion (PLIF) while 31 cases underwent minimally invasive transforaminal lumbar fusion (MIS-TLIF) assisted by disposable dilating tube． The perioperative characteristics were compared between the two groups．Back and leg pain Visual Analogue Scores (VAS), Oswestry Disable Index (ODI) and radiological examination were performed preoperatively, postoperatively, and during follow-up． Results All patients underwent successful operation and have been followed up for more than 2 years． There was no significant difference in demographic data, preoperative VAS and ODI scores, and operative time between two groups (P> 0．05)． There were less operative blood loss and post-operative drainage in MIS-TLIF group than PLIF group (121±57．8) ml vs (256±176．3) ml, P< 0．01; 0 ml vs (293±187．2) ml, P< 0．01． The patients of MIS-TLIF group had shorter postoperative time in bed and hospitalization time than PLIF group (1．6±0．5) d vs (3．2±1．1) d, P< 0．01; (4．4±1．2) d vs (8．1±3．8) d, P< 0．01． During the follow-up period, the VAS and ODI scores improved significantly compared with preoperative data in both groups (P< 0．05), while there was no significant difference between two groups at 3, 6 and 12 months postoperatively． Conclusion MIS-TLIF and PLIF can achieve similar clinical outcomes for massive lumbar disc herniation, but as for the perioperative blood loss, postoperative in-bed time, postoperative back pain, MIS-TLIF is superior to PLIF．