Background:
The cerebello-pontine angle (CPA) is an important region in the skull base which can harbour a variety of pathologies. Because it is surrounded by numerous vital structures, surgical access is a challenge, more so when distorted by disease. Microscopes have successfully guided CPA surgery over the past three decades. CPA endoscopy has evolved today as an alternative way to explore this intriguing region with minimal morbidity to collateral structures.

Discussion:
CPA endoscopy has been introduced on an experimental basis into a range of CPA surgeries, including assistance in lower cranial nerve tumor removal, microvascular decompression, vestibular neurectomy, and assistance in auditory brainstem implantation. CPA endoscopy is currently used as a surgical adjunct to the operating microscope, and it has the potential to become standard in many CPA surgeries.

Conclusions:
CPA endoscopy has evolved from a diagnostic to a therapeutic tool because it allows near and clear visualization of the CPA with in-depth view of the various nerve roots arising from the brainstem and their exit foramina. This review evaluates the current status and future directions of endoscopic technology and its role in skull base surgical practice.