Thoracic myelopathy is commonly caused by spinal canal stenosis, often due to hypertrophied or ossified ligamentum flavum [1]. The presence of thoracic disc herniation at the level of canal stenosis exacerbates the myelopathy. In such cases, simultaneous treatment of thoracic canal stenosis and disc herniation is essential to enhance neurological recovery [2, 3]. Unilateral biportal endoscopic (UBE) approaches have been reported as ideal surgical techniques for safely treating thoracic canal stenosis, including ossification of the ligamentum flavum (OLF) [4–6]. However, accessing the disc space after thoracic laminotomy is technically challenging due to the narrow space between the dural sac and the facet joint. Excessive dural retraction can result in irreversible spinal cord injury. By overcoming these anatomical limitations, we can simultaneously address thoracic disc herniation and thoracic OLF across all thoracic levels using the UBE thoracic posterior approach.