Otolaryngology-head and neck surgery is very complex due to its specificity that makes our management of the disease very complicated. Endoscopic surgery is a surgical method that has been widely performed in recent years. The application of nasal endoscopy, otolaryngoscopy and laryngeal endoscopy techniques has changed the traditional surgical route. Nowadays, nasal and sinus and laryngeal surgery has fulfilled the principle of minimally invasive, which is a mechanism for complete removal of lesions while preserving organ structure and function, reducing intraoperative trauma, bleeding and lowering suppression of immune function, short anesthesia time, less bleeding, and lowering the incidence of surgical complications. The nasal endoscopic technique progresses: nasal endoscopic surgery is to thoroughly remove the lesions of nasal cavity and sinuses under direct vision and television surveillance according to the extent of the lesions, preserving the mucous membrane as much as possible while preserving the middle turbinate, so that the nasal cavity and sinuses can be restored to normal physiological function under minimally invasive surgery while sinusitis and nasal polyps can be cured at the same time. The application of nasal endoscopy for the diagnosis and treatment of sinusitis completely removes the lesion and restores sufficient ventilation and unobstructed drainage to the diseased sinuses, while the sinus function is basically well preserved. Removal of adenoids by power cutting system under nasal endoscopy provides clear field, smooth trauma and simple operation, which can significantly shorten operation time and reduce complications, and is equally suitable for both adult and pediatric patients. Based on the continuous development of nasal endoscopy, minimally invasive surgery has been involved in diseases other than inflammation, such as nasal neurosurgery and nasal-ocular related surgery. For example, nasal endoscopy has been applied to perform nasal and sinus entropion papilloma resection, nasopharyngeal angiofibroma removal, transsphenoidal pituitary tumor removal, transseptal pterygoid approach optic nerve canal decompression and nasal endoscopic lacrimal sac rhinoplasty for chronic lacrimal sac. The diagnosis rate of patients with cerebrospinal fluid leaks in the anterior cranial fossa and pterygoid fossa can be 95% to 100% with 3D CT examination combined with nasal endoscopy, and endoscopic repair of cerebrospinal fluid nasal and sinus leaks can be done with less tissue damage and under direct vision. Transnasal surgery is lightly damaged, and the therapeutic effect is significantly better than that of craniotomy. In the past, after radical surgery of maxillary and frontal sinuses, patients’ symptoms often persisted or worsened, and now it is found that obstruction of ventilation and drainage of the sinus-oral nasal tract complex is the main cause of the development of sinusitis. Functional nasal endoscopy treats the sinonasal complex as a whole to address the obstruction of ventilation and drainage in this area, and inflammatory lesions in each sinus can be cured. In order to reduce minimally invasive treatment in surgery often lesion removal is not enough, the use of computer systems, surgical cavity localization, preoperative three-dimensional reconstruction CT scan, plus the positioning of the endoscope to provide intraoperative application of CT image guidance, combined with endoscopy can completely eradicate the lesion. Children with intraorbital complications due to acute sinusitis should undergo early minimally invasive nasal endoscopic surgery to improve sinus drainage and ventilation. Surgical treatment of chronic dacryocystitis has now been replaced by endoscopic lacrimal sac rhinoplasty. Nasal endoscopy for chronic dacryocystitis has a clear surgical field of view, little damage, accurate positioning, and good postoperative efficacy, especially with the advantages of few complications and no facial scarring. Minimally invasive surgery has been widely carried out in the field of otolaryngology, and its advancement has been widely recognized. However, the indications and contraindications for surgery should be strictly mastered in the selection of cases, especially for nasopharyngeal angiofibroma, skull base tumor, transsphenoidal pituitary tumor resection and judgment of the scope of vocal cord lesion should be carefully engaged, and minimally invasive surgical approach should be abandoned for nasopharyngeal angiofibroma that is difficult to be removed. Minimally invasive surgeons should have familiar anatomical knowledge and good operating techniques. Although endoscopic surgery in the nose and sinuses, larynx and ear has realized the principle of minimally invasive surgery, with sensitive operating instruments to facilitate the operation, as well as a three-dimensional television endoscopic system and image processing to complete the three-dimensional vision. It is also necessary for ENT physicians to pay extensive attention to various new technologies and advances to be applied and corroborated in a timely manner in clinical practice.