Experience with more than 200 neuroendoscopic procedures taught us the advantages and disadvantages of the different endoscope designs. Using an endoscope with a sheath with separate channels for the endoscope, the instruments as well as for rinsing and suction we found advantages in rinsing properties, handling, and preciseness of instrument steering. On the other hand an endoscope with a sheath with a singular channel for the endoscope itself, the instruments, rinsing, and suction the advantages were better in visualization of the instruments, more available instruments, and easier extraction of larger specimen. The knowledge of these advantages makes it possible to select the adequate endoscope regarding its design, especially in more complicated cases.