No surgical speciality has been more radically changed by the advent of endoscopy than urology. While the lower urinary tract is accessible through an elastic capacious urethra, the upper urinary tracts are protected by their deep seated anatomical position and their narrow, fragile ureters. In the last 5 years the clinical problems of intrarenal access have been overcome. The renal collecting system can be approached directly through the loin, following radiological puncture and dilatation of a nephrocutaneous tract, or through the ureter with the new flexible and rigid ureterorenal endoscopes. The combination of these new access techniques with the development of sophisticated instrumentation for stone destruction have resulted in the virtual abandonment of conventional stone surgery. Doubtless the endoscopic techniques for dealing with transitional cell tumours, dividing strictures and endoscopic reconstructive surgery will have a similar impact on these fields in the very near future. This paper describes the use of percutaneous renal surgery (PRS) and ureterorenal surgery (URS) which together form the new super-speciality of Endourology.