TMJ arthroscopy is a minimally invasive procedure that has been used for treating internal derangement of the TMJ for years. It started with arthroscopic lysis and lavage and with time-operative procedures such as electrocoagulation, coblation, or even discopexy. It requires a high learning curve and a special instrument to be able to perform it. The instruments needed are usually delicate and can break easily such as the arthroscopic lens, the cannulas, the trocars and intraarticular instruments such as probe and scissors. It is done normally under general anesthesia, although few surgeons perform it locally. It gives very good results in most patients regarding improving mouth opening and pain reduction. Its complications are usually rare and can be avoided with excellent instrumentation and well-trained surgeons.