The paper examines the features of the establishment and development of endoscopic neurosurgery in the first three stages of its history: rigid (1795–1932), semi-flexible (1932–1958), and in the early fibre-optic period (1958–1981). It also examines the discussion surrounding ideas and techniques of surgical approach in neurosurgery. The era of endoscopic examination in surgery began between the late 18th century and the early 19th century (Philipp Bozzini, 1795; Pierre Salomon Ségalas, 1826; John Dix Fisher, 1827). However Antonin Jean Desormeaux (1853), who created an optical device for examining the urogenital tract and called it the “endoscope”, is regarded as the “father of endoscopy”. The era of “proper” endoscopes begins with the work of Max Nitze, who developed a method of examining the bladder using a cystoscope that he had invented (1877–1879). The idea of visual examination of internal organs without a large incision of the skin was first advanced in 1901 (Georg Kelling; Dmitry O. Ott) Endoscopy made its way into neurosurgery in the early 20th century when, for the first time, Victor Darwin Lespinasse used an endoscope to examine the choroid plexus (1910). Walter Edward Dandy (examined brain ventricles using an endoscope; coined the term “ventriculoscopy”), Jason Mixter (inventor of endoscopic triventricu-lostomy; became one of the founding fathers of minimally invasive surgery) were the pioneers of neuroendoscopy. Rapid advances in physics and optics aided the improvement of endoscopes. Authors of the paper also examine surgical approach challenges in endoscopic neurosurgery: transnasal – Jules Hardy, Hae-Dong Jho, Ricardo Carrau, transcranial – Victor Horsley, transbasal, upper nasal transsphenoidal – Hermann Schloffer, transseptal – Theodor Kocher, transsphenoidal – Harvey William Cushing, who later abandoned this approach in favour of the transcranial approach, and Norman Dott, direct transethmoi dal approach – Oskar Hirsch and others.