Spinal fusion surgery has the potential to alleviate pain, improve functional ability, and maximize overall quality of life. Recognizing not only the importance to preserve as much normal human anatomy and physiology as possible but also to take into account the overwhelming economic, social, and psychological burden that open surgery may place on both patient and society, the concept of minimally invasive surgery (MIS) was born. The goals of MIS are to achieve the same results as conventional open surgery while striving to minimize soft tissue destruction, decrease intraoperative blood loss, reduce postoperative pain and hospital length of stay, and most importantly accelerate return to preoperative functional status. Endoscopic spinal fusion represents a step in the evolution of minimally invasive spine surgery that now allows us to even perform procedures such as the transforaminal lumbar interbody fusion (TLIF) without general anesthesia, removing yet another possible cause of surgical morbidity. Endoscopic techniques for fusion in the lumbar spine have been developed for every approach, and techniques also exist for both cervical and thoracic applications.