Objective: To compare the clinical outcome between minimally invasive transforaminal approach and traditional posterior approach in the treatment of single level lumbar tuberculosis, and to evaluate the safety and reliability of minimally invasive transforaminal approach for single level lumbar tuberculosis. Methods: 73 patients with single level lumbar tuberculosis were followed up.Among them, 40 cases received traditional posterior surgery, and 43 cases received minimally invasive transforaminal surgery. The operation time, intraoperative blood loss and postoperative drainage were compared between two groups. Clinical outcomes in terms of back pain VAS score and ODI score were performed before surgery and during follow-up. Fusion rate between the two groups was comparied at the time of last follow-up. Results: After surgery, all patients significantly reduced back pain, and body temperature returned to normal within 2 week. The operation time, intraoperative blood loss and postoperative drainage in minimally invasive transforaminal surgery group were 180± 35, 350± 50, 320± 80 respectively, which were significantly less than 180± 35, 350± 50, 320±80 respectively in traditional surgery group (P<0.05). When followed up before surgery and 1 month, 3 month, 6 month, 12 month, final time after surgery, the low back pain VAS scores were 8.7± 1.2, 4.5± 1.1, 3.5± 1.1, 2.0± 1.4, 1.3± 0.5,1.2± 0.5 and the ODI scores were(77± 6)%, (31± 5)%, (23± 8)%, (14± 6)%, (8±4)%, (7± 3)% respectively in minimally invasive transforaminal surgery group. At the same times, the VAS scores were 8.5± 1.1, 2.7± 0.7, 2.1± 0.6, 1.9± 0.7, 1.1± 0.4, 1.1± 0.4, and the ODI scores were (78± 5)%, (23± 6)%, (14± 7)%, (12± 5)%,(7± 2)%, (7± 2)% respectively in traditional surgery group. The VAS and ODI scores in minimally invasive transforaminal surgery group were lower than that of traditional posterior surgery group at 1 and 3 months after operation (P<0.05), and there was no difference between two groups regarding to VAS and ODI scores at other times (P>0.05). All the patients achieved spinal fusion at the final follow-up. Conclusion: For single level lumbar tuberculosis, minimally invasive transforaminal approach can achieve the same therapeutic effect and the fusion rate with traditional posterior surgery, which was highly reliability because of lower bleeding, operation time and drainage. [ABSTRACT FROM AUTHOR]