Objective To evaluate the efficacy and safety of percutaneous radiofrequency thermocoagulation (RFT) combined with collagenase chemonucleolysis (CC) in the treatment of cervical disc herniation (CDH) in county medical institutions, and to compare it with RFT alone. Methods A retrospective analysis was conducted on the clinical data of 148 patients with CDH who were admitted to the Department of Pain Medicine, Taikang People’s Hospital from January 2023 to June 2025. The patients were divided into the combined group (enrollment period: July 2024 to June 2025, RFT＋CC, 100 cases) and the control group (enrollment period: January 2023 to June 2024, simple RFT, 48 cases) based on the treatment plan. Both groups underwent the corresponding surgical procedures under the guidance of a C-arm X-ray machine. The visual analogue scale (VAS) and neck disability index (NDI) of the two groups of patients were compared before and at 1 week, 1 month, 3 months and 6 months after surgery, and the comprehensive efficacy was evaluated according to the modified MacNab criteria. Results All 148 cases were followed up, with an average follow-up of (8.2±2.1) months. The VAS and NDI of the combined group were significantly lower than those of the control group at each time point after operation (all P＜0.05), and the VAS and NDI of the combined group at 1 month, 3 months and 6 months after operation were significantly lower than those of the control group during the same period (all P＜0.05). In addition, the total excellent and good rate of modified MacNab at the last follow-up was 91.00% (91/100) in the combination group and 75.00% (36/48) in the control group, and the difference was statistically significant (P＜0.05). The excellent rate of single-segment treatment in the combined group was 80.00% (64/72), which was higher than that of multi-segment treatment at 50.00% (14/28) (P＜0.05). Conclusion The combination of RFT＋ CC in the treatment of CDH is feasible in county medical institutions, and the curative effect is better than that of RFT alone, especially for primary patients with single-level protrusion and unwilling to undergo open surgery.