Vascular lesions play a significant role in the pathogenesis of connective tissue diseases. Capillaroscopy is considered a practical tool for diagnosing and monitoring of patients with connective tissue diseases. Furthermore, capillaroscopy can help in the selection of patients that need more aggressive therapeutic interventions. Nail fold capillary microscopy can be performed with various optical instruments such as ophthalmoscope, photomacography system, stereomicroscope, conventional optical microscope. However, quality of study of the microcirculation has improved significantly with the use of videomicroscopy equipment with optical contact probes. The observation of the capillary bed is usually made at nailfold, because here capillaries run parallel to the skin surface, whereas in other areas they are perpendicular to skin surface. Capillaroscopy is considered a practical tool for diagnosing and monitoring of patients with connective tissue diseases. Furthermore, capillaroscopy can help in the selection of patients that need more aggressive therapeutic interventions. NVC represents the best method to analyze microvascular abnormalities in rheumatic diseases and also in some non rheumatic diseases especially those with vascular affection.