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Fluorescence is a long known physical phenomenon which has relatively recently entered endoscopic surgery. Fluorescence is generated by illuminating certain material with light of a specific colour resulting in the generation of light with a different colour. In most cases the clour has a longer wavelength; e.g. applying blue light can result in a green or red fluorescence signal. Use of fluorescence facilitates an easier detection of tumours or a better delineation of tumour margins during surgery or enables functional assessment in real-time. This will help to achieve a better outcome of patient treatment. The technology of fluorescence aided imaging is facing some challenges. One of these challenges is related to the availability of suitable and safe fluorescence markers which can be administered to patients. Currently, only very few of these markers are available, i.e. approved by regulatory authorities; others are under development. Fluorescence markers are regarded as pharmaceuticals resulting in a lengthy development and approval process. Another is related to the suitable surgical equipment, i.e. the imaging systems have to be modified in such a way that they are capable to be used for both white light as well as fluorescent imaging without impairing the surgical workflow too much or having a negative impact on the high definition imaging quality which is regarded today as a standard. There is an additionally challenge related to the different physical properties of the fluorescence markers. Camera, light system and endoscopes have to be adapted to allow the use with the different markers. Fluorescence imaging is an interesting technology with a great potential for real-time imaging during endoscopic surgery.