Advances in video technology have enabled the incorporation of high-resolution electronic imaging of an operative field during microneurosurgical and endoscopic procedures. While current video-based monoscopic camera and monitor systems produce an excellent image, the third dimension is lacking and the operative field and image are at different locations. We describe a head-mounted display (HMD) that allows the surgical team to simultaneously visualize a surgical field and a high-resolution magnified stereoscopic image which includes a picture-in-picture capability. Stereoscopic HMDs should result in improved efficiency and safety in both endoscopic and open microsurgical procedures. Additional uses relate to surgical training and operative rehearsals.