OBJECTIVES: To investigate the application effect of mixed reality (MR) holographic imaging technology in the clinical surgical treatment of spinal cord glioma. METHODS: The clinical data of 53 patients with spinal cord glioma who underwent surgical treatment in the Neurosurgery Department of our hospital from January 2017 to May 2020 were retrospectively studied. All the patients were divided into two groups according to different assistive technologies during the surgery: the observation group and the control group, with 30 cases and 23 cases respectively. Patients in the observation group received MR holographic imaging technology intraoperatively, while those in the control group received ultrasound. The surgical conditions of the two groups: the rate of complete resection of tumor lesions and the evaluation accuracy of complete resection were compared. Patients were followed up for 12 months in the outpatient department after surgery, and the recovery of postoperative spinal physiological function was evaluated based on imaging review and MMS scale grading, and the recurrence was obtained. RESULTS: There was no statistical significance in the basic clinical conditions between the two groups (P>0.05), and the total tumor resection rate in the experimental group was 96.67%, and that in the control group was 82.61%, showing a statistically significant difference (P<0.05). Based on enhanced MRI examination as the standard, the evaluation accuracy of intraoperative complete tumor resection in the experimental group was 93.33%, significantly higher than that in the control group (73.54%), with a statistical significance (P<0.05). The incidence of postoperative complications was 3.33% in the experimental group and 21.74% in the control group, with a statistically significant difference (P<0.05). Postoperative follow-up showed that good recovery rate of spinal cord function in the experimental group was 56.70%, and that in the control group was 41.09%, with a statistically significant difference (P<0.05). The recurrence rate was 0 in the experimental group and 4.34% in the control group at follow-up, with no statistically significant difference (P>0.05). CONCLUSIONS: With the application of MR holographic imaging technology in the surgical treatment of spinal cord glioma, critical clinical value can be realized. Specifically, the resection degree of spinal cord glioma can be displayed in real time, accurately, and three-dimensionally, the effect of surgical resection can be improved, surgical complications can be diminished, and the recovery of spinal cord function can be accelerated.