Introduction: Currently, unilateral biportal endoscopy (UBE) as a new minimally invasive technique has been applied to conventional arthroscopic systems for the treatment of spinal disease. Aim: To analyze the clinical effect of UBE in the treatment of lumbar diseases. Material and methods: A systematic review of the literature published up to May 2021 was performed in the English database PubMed, Embase, and the Chinese database CNKI, Wanfang. There were 9 studies included in this systematic review and meta-analysis. The outcomes measured included operative time, Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). Results: A total of 528 patients were collected from the selected 9 articles. The random effects model showed that the value of pooled effect mean deviation (MD) in each study was 58.62 (95% CI (57.53, 59.72), p < 0.001). At the end of postoperative follow-up, the standard mean difference (SMD) VAS scores of legs -4.12 (95% CI (-5.15, -3.09), p < 0.001) and back -3.10 (95% CI (-4.35, -1.84), p < 0.001) were lower than the preoperative values. At the same time, the results of the random-effects model showed that the SMD of the ODI score was -7.07 (95% CI (-8.69, -5.46), p < 0.001) and at the end of follow-up was lower than preoperatively. Conclusions: UBE surgery has a good clinical effect in the treatment of lumbar diseases, and can be widely used in the treatment of free prolapse lumbar disc herniation (LDH).