Proper lighting and visualization have always been critical to safe surgical interventions for the very reason that, in general, one cannot operate if one cannot see. To this end, there has been tremendous innovation over the past century in developing enhanced lighting techniques to aid in visualization and anatomic identification. These enhanced lighting techniques take on special importance in endoscopic surgery given two fundamental departures from traditional, open surgery: (1) the narrowed minimally invasive apertures with which to get light in and light out and (2) the indirect nature of visualization, a result of optical manipulation and digital image transformation.