In order to determine the suitability of new microlaparoscopes of < 2.0 mm diameter for diagnostic laparoscopy, 28 small diameter laparoscopies (SDL) were performed during a 4 month period. These cases were performed under general anaesthesia with immediate follow-up confirmation with conventional laparoscopic equipment (group I). An additional 13 SDL procedures were performed under analgesic sedation plus local anaesthesia and were well tolerated by the patients (group II). For group I, the visualization results were comparable in 27 out of 28 procedures. In group II, patients were highly satisfied and reported less post-procedural discomfort and minimal scar formation due to the smaller access ports. In this study, two different types of microlaparoscopes were used; while both were adequate, the newer high-resolution microlaparoscope delivered an image much more similar to conventional laparoscopy and required little or no change in technique in order to obtain images. This new endoscopic technology, with optical performance comparable to that of conventional laparoscopy, has been demonstrated to be a useful procedure for certain clinical indications.