Visualization is a cornerstone of vitreoretinal surgery, directly influencing surgical precision, safety, and outcomes. Over time, visualization systems have evolved in parallel with advancements in surgical techniques, transitioning from the early direct ophthalmoscope to sophisticated digital and three-dimensional platforms. Each innovation has expanded the surgeon’s ability to identify fine retinal structures, improve intraoperative decision-making, and perform delicate maneuvers with greater confidence. This chapter provides a comprehensive overview of visualization systems used in vitreoretinal surgery, including their historical development, optical principles, and modern technological advancements. Foundational tools such as the indirect ophthalmoscope remain relevant due to their wide field of view and utility in both clinical and surgical settings. The introduction of operating microscopes marked a major breakthrough, enabling magnification, stereoscopic vision, and improved illumination, all of which significantly enhanced surgical performance. Recent developments have further transformed the field. Wide-field viewing systems allow for better visualization of peripheral retinal pathology, while digital and three-dimensional visualization technologies offer enhanced depth perception, ergonomics, and educational value. Integration with imaging modalities such as optical coherence tomography has enabled real-time intraoperative guidance, further improving surgical accuracy. Additionally, innovations such as augmented reality, heads-up display systems, and robotic assistance are shaping the future of vitreoretinal surgery. These technologies aim to enhance precision, reduce surgeon fatigue, and expand access to specialized care through telemedicine and remote assistance. Understanding the evolution and application of visualization systems is essential for optimizing surgical outcomes and advancing patient care in modern ophthalmology.