Objective. To improve treatment outcomes in patients with sciatic nerve neuropathy. Material and methods. The first results of endoscopic sciatic nerve decompression in 6 patients with sciatic neuropathy (mean age 47±6.7 years) are presented. The authors developed and described new and unique technique for this procedure. All patients suffered severe neuropathic pain syndrome with neurologic disorders. All patients underwent endoscopic sciatic nerve decompression in prone position. Results. Mean VAS score of preoperative pain syndrome was 7.8±0.37. In 3 months after surgery, this value decreased up to 1.5 scores. Complete regression of pain syndrome and significant reduction of neurologic symptoms were noted in 5 out of 6 patients (83%). Conclusion. Primary data characterize the developed method as an easy, minimally invasive and effective procedure for pain relief and fast recovery of lower extremity function in these patients. © 2021, Media Sphera Publishing Group. All rights reserved.