Objective: To investigate the therapeutic effect of transforaminal endoscope in patients with spinal metastases. Methods: Clinical data of 28 patients with spinal metastases admitted to our hospital from May 2015 to May 2019 were retrospectively collected. According to different surgical methods, they were divided into control group (20 cases) and experimental group (8 cases), among which control group was treated with traditional open palliative decompression, while the experimental group was treated with transforaminal endoscopic decompression. The surgery and recovery indicators were compared between the two groups, including surgery time, incision length, postoperative drainage volume, out of bed activity time, length of hospital stay, the Japanese Orthopaedic Association (JOA) scores of 7 days after surgery, pain degree, complications (wound infection, transient reduction of muscle strength, hypoproteinemia with wound drainage and delayed healing), and activity of daily living. Results: The surgery time, incision length, postoperative drainage volume, out of bed activity time, and postoperative length of hospital stay of the experimental group were all less than those of the control group, and the JOA score of 7 days after surgery was higher than that of the control group, showing statistically significant differences (P < 0.05). VAS scores of the experimental group on the day 1 and day 7 after surgery were lower than those of the control group, with statistically significant differences (P < 0.05). The incidence of complications in the experimental group was slightly lower than that in the control group, but the difference was not significant (P > 0.05). Conclusions: Transforaminal endoscope used in suitable patients with spinal metastases can greatly reduce the incision length, soft tissue and bone tissue damages, and postoperative drainage, promote early mobilization and early discharge, and reduce a series of complications due to hemorrhage and hypoproteinemia, which has a better early clinical effect in comparison with the traditional open palliative decompression.