A majority of ureteral injuries occur during gynecological operations, and lower urinary tract injury is one of the most common reasons for medical litigation against gynecologists. Intraoperative cystoscopy is safe and allows for immediate recognition and easier repair of injury to lower urinary tract. Transurethral cystoscopy is performed using 30° or 70° rigid telescope with 17 French sheaths. A thorough survey of the bladder made with special attention to the portions of the bladder potentially jeopardized by the operative procedure. A 30° suprapubic cystoscopy with light source and retrograde filling of bladder is an alternative to transurethral cystoscopy for evaluation of lower urinary tract during pelvic surgery with an abdominal approach in supine position. Bladder injuries are staged from grade 1 to grade 5. Intraoperative cystoscopy detects most unsuspected injury (level B), thus routine cystoscopy recommended at the time of laparoscopic hysterectomy and urogynecological surgery (level B).