The aim of this chapter is to focus on the operation theater setup and instruments used in hysteroscopy. Hysteroscopy is a procedure that involves direct visualization of cervical canal and uterine cavity. Office hysteroscopy allows minor pathologies to be treated in an outpatient setting. Surgical hysteroscopic procedures, or in other words, major hysteroscopic surgery, are performed in the operating room. Instruments used are distending media, light source, camera, telescope, diagnostic and operative sheaths, and accessory instruments. This chapter covers the media for distending the uterine cavity, light source, imaging systems, diagnostic sheaths, operative hysteroscopes, electrosurgical unit for high-frequency surgery, and maintenance and sterilization of instruments.