From the dawn of medicine, low back pain has been one of the most frequent and complex pathologies. The treatment of this entity has always been a matter of interest throughout history. To such extent that ever since Bozzini first described the endoscope, in 1806, the possibility of direct visualization of the spinal canal has been explored seeking improved diagnostic and treatment alternatives. In this article we will navigate through the historical developments and state-of-the-art in epidural endoscopy focusing on possible future technological breakthroughs that will permit care of spinal pathology through increasingly less invasive techniques.