Electrosurgical instruments are routinely and daily applied at a variety of indications in Otorhinolaryngology. They can be used for cutting, coagulation and devitalisation. All have in common that the high frequency energy is transported into the tissue via an instrument and by this causes a thermal change. Depending on the duration and characteristic of the electricity a vaporisation of the tissue is effected through coagulation, devitalisation and carbonisation. The knowledge of the effects on the tissue by the choice of the different instrument parameters and application systems is essential for an ingenious therapeutically indication. In principal the following application methods for electrosurgery by modulation of the high frequency parameters are distinguished: the monopolar and the bipolar coagulation and devitalisation and the monopolar and the bipolar cutting. This article deals with the physical basis, the effects in the tissue as well as the single application methods of the high frequency surgery.