Several forces are acting on hysteroscopic surgeons to promote the 100-year-old practice of office hysteroscopy. It remains the surgeon's responsibility to triage patients properly to the office or hospital, and it is hoped that the principles discussed herein are helpful in that thinking. Office hysteroscopy implies more adaptability in the surgeon than in the surgeon's instruments. The indications, contraindications, and technique of office hysteroscopy do not differ significantly from those of hysteroscopy in the hospital on an awake patient. With current economic forces, instrumentation, and surgeon interest and training, office hysteroscopy will probably grow in popularity over the next several years.