Endoscopy is a new procedure in neurosurgery that uses optical magnification and video-assisted endoscopes to guide the hand to hard-to-reach locations. Despite extensive trials and meta-analyses, no definitive results have been published on its benefits. Neuroendoscopy has expanded beyond ventricular operations to treat various neurosurgical conditions, including cyst fenestration, tumor biopsy, tumor excision, and metastatic disease evaluation. It is beneficial for patients with hydrocephalus, intraventricular cysts, and concurrent hydrocephalus. Intracranial cysts are ideal for neuro-endoscopic therapy, and it can treat cystic craniopharyngiomas, dysontogenic tumors, gliomas, and metastases. Endoscopic tumor biopsy is a reliable technique for ventricle brain tumors. our study treated 480 hydrocephalus patients using endoscopic third ventriculostomy, accounting for 50.5% of cases. The most common cause was Sylvius aqueduct stenosis. Endoscopy was beneficial for treating colloidal cysts, arachnoid cysts, pituitary adenoma, and craniopharyngioma. It also served as a complement to microsurgery in 55 cases. Neuroendoscopy improved sciatic pain in 15 patients who underwent lumbar discectomy, with only minor issues due to the surgical scar. Neuroendoscopic surgery is expected to advance significantly in the future, with advancements in camera and optical technology, surgical instrument design, navigation systems, multiport surgery, and improved microsurgery.