The surgical microscope has revolutionized the practice of modern spine surgery. The major advantages of the microscope include better illumination, magnification and coaxial vision. It has also contributed to the welfare of the surgeon through improved ergonomics and opportunities to demonstrate surgical nuances to a training resident. However, there are limitations to its role in complex, long segment fixations and a potential for higher risk of surgical infections secondary to intraoperative contamination. © 2013 The Authors ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.