Introduced to the field of plastic surgery in the early 1990s, surgical endoscopy has expanded rapidly with applications across the broad range of plastic surgery. Although basic principles and concepts have remained the same, there have been advances in both instrumentation and surgical ingenuity, allowing these broader applications. The numerous applications of the endoscope were reviewed and evaluated. Although some applications such as the endoscopic forehead lift and transaxillary endoscopic augmentation seem to have received general acceptance and are used across a broad spectrum of plastic surgery practices, others such as endoscopic muscle harvest have not gained such widespread acceptance. Also, there are areas such as endoscopic microvascular surgery that await advances in technology and instrumentation.