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The article reviews the advancements in instrumentation in the operating room that augment the speed, safety or outcomes of endoscopic sinus surgery (ESS). The article aims to update the Rhinologist on recent perioperative instruments that may benefit their practice.The greatest advancements in the recent years have been in the field of visualization and optics. The introduction of high definition and ultra high definition 4K camera and screens supported by improvements with three-dimensional and variable angled endoscopes have greatly enhanced the quality and range of the visual information available to the sinus surgeon. This is closely supported by flexibility and enhanced functionality of the powered instrumentation with bipolar, monopolar and malleable blades and ever increasing more powerful burs.Recent years have seen notable developments in the areas of optics, cameras and powered instruments to support the sinus surgeon. This article summarizes these developments and highlights the major benefits of these developments.