Innovative advances have recently occurred regarding instrumentations, energy sources, and devices aimed at facilitating surgical procedures in terms of efficient hemostasis, dissection, safety, and reduction in surgical time. In the present chapter, we introduce to the practice of otologic surgery a new ultrasound instrument: the Piezosurgery® device (Mectron Medical Technology, Genoa, Italy). The piezoelectric device is an ultrasound bone scalpel, it uses low-frequency ultrasonic waves (24.7-29.5 kHz), the applied power can be modulated between 2.8 and 16W, and the machine is programmed in accordance to the density of the bone cut. The main advantage of the piezoelectric device is its selective cut that recognizes tissue hardness and works only on mineralized structures without soft-tissue damage. In our experience, the piezoelectric device has been used successfully in otologic surgery, nasal surgery and maxillofacial surgery. © 2012 by Nova Science Publishers, Inc. All rights reserved.