Endoscopy of the spinal canal – epiduroscopy (EDS) – has proven to be a safe, efficient and future-oriented interventional endoscopic procedure for everyday clinical use in diagnosing and managing pain syndromes. Epiduroscopy can be used in the sacral, lumbar, thoracic and even cervical regions of the spine to identify pathological structures, carry out tissue biopsies and perform epidural pain provocation tests to assess the pain relevance of visualized anomalies, making it an excellent diagnostic tool. Spinal endoscopy allows targeted epidural analgesic pharmacologic therapy for affected nerve roots or other painful regions in the epidural space. Treatment options provided by epiduroscopy include laser-assisted adhesiolysis or resection of pain-generating fibrosis, catheter placement, as well as support with other invasive procedures for pain relief. Professional EDS management enhances a multimodal philosophy and opens up new treatment strategies for patients. If used early on, it can control pain well before chronicity sets in.