The first microscopes created allowing the examination of the endothelial layerEndothelial layer date back to the year 1968. Since then, many advances were made until reaching the non-contact specular microscopySpecular microscopy, currently considered as the method of choice for examining the endothelial layerEndothelial layer. This microscope allows the objective assessment of the endothelial layerEndothelial layer using 4 important parameters: Endothelial cell densityEndothelial cell density (ECD), cell area, pleomorphism and polymegethism. Hereby, endothelial integrity and vitality can be assessed and many diseases of the endothelial layerEndothelial layer can be detected such as cornea guttataCornea guttata, corneal decompensation, posterior polymorphous corneal dystrophyCorneal dystrophy or iridocorneal endothelial (ICE) syndrome. Further advancement in this diagnostic modalityDiagnostic modality is currently incorporating artificial intelligenceArtificial intelligence as an image analysis tool providing automatic segmentation and analysis of the endothelial images.