The role of intraoperative angioscopy continues to evolve. Angioscopy is now a valuable adjunct in the management of the patient with peripheral vascular disease. Endoscopic visualization of the blood vessels offers the vascular surgeon the promise of unsurpassed diagnostic accuracy. The direct three-dimensional image obtained with angioscopy provides more infor¬mation on luminal morphology than either contrast arteriography or intravascular ultrasound. Advances in fiberoptic technology have today made angio¬scopy, which was once only an investigational device, an important diagnostic and therapeutic tool for the vascular surgeon in the management of peripheral vascular disease. The most well established indication for angioscopy is preparation of the saphenous vein for in situ bypass (vein evaluation for effective valvutomy). Angioscopies are used for assessement of vascular anastomoses, diagnosis and management in peripheral arterial thromboembolism, assessement of vascular trauma, guidance of arterial dilatation and the use of angioscope to guide stent deployment.