MTI Hayatabad Medical Complex Peshawar became the first public sector hospital to start advance endoscopic surgeries in Khyber Pakhtunkhwa. MTI-HMC successfully completed 131 endoscopic Spine Surgeries in three years. Second Endoscopic Spine Surgery Workshop was conducted at HMC Peshawar on 20th Oct 2021 in which 5 Endoscopic Spine surgeries were preformed by Professor Arif Khan Head of Orthopedic & Spine unit HMC. Dr. Ali Guvin Visiting surgeon from Riwospine Germany revisited HMC after 3 years. He had helped in starting Endoscopic Spine at HMC in Oct 2018. Since 2018 October 131 cases or Endoscopic Spine have been preformed and multiple presentations nationally and internationally. The results have been published in journals with encouraging reviews. HMC Peshawar is the first public sector hospital to introduce this advancement in Spine Surgeries in Khyber Pakhtunkhwa. The Workshop was aimed at applying new advanced techniques in Spine Surgeries in the province. Mohammad Arif Head of Orthopedic & Spine department HMC Peshawar said that HMC Peshawar has completed 131 Endoscopic Spine surgeries since 2018. This training will help young Spine surgeons to get acquainted with such advance techniques and develop the specialty further.