Spine surgeons have recently developed more advanced and less invasive techniques. One significant example of recent surgical innovation is the advent of endoscopic-assisted spine surgery. Endoscopic lumbar interbody fusions are increasingly used to treat lumbar degenerative disease in a minimally invasive approach that minimizes pain and maximizes outcomes. Numerous technical refinements to ultraminimally invasive approaches have occurred since their initial use, which has resulted in substantial clinical benefit for patients that remains stable over time. Serious complications can occur and thus, the spine surgeon adopting endoscopic techniques must be aware of the early learning curve.