Stifle surgery likely represents the most common orthopedic procedure performed by small animal surgical specialists. While stifle arthroscopy is standard of care in human surgery, it remains relatively infrequently used in small animal surgery. Needle arthroscopy can provide a easier means of entry than traditional arthroscopy for surgeons looking to add stifle arthroscopy to their practice. At the same time it can improve efficiency and economics for surgeons experienced in stifle arthroscopy. We have demonstrated in our practice that in a large percentage of cases, particularly dogs with partial cruciate ligament ruptures, needle arthroscopy can: shorten procedure times, save costs to the hospital and client, decrease equipment damage, improve meniscal visualization, decrease equipment processing time, increase doctor and staff efficiency and satisfaction. During the 1990’s and 2000’s arthroscopy dramatically aided in determination of cause in forelimb lameness of unknown origin in small animals. Needle arthroscopy is providing a similar dramatic improvement in determination of cause of hind limb lameness of unknown origin, particularly in the documentation of very early yet clinically significant cruciate disease. The term “revolutionary” is often overused but could justifiably be used in the description of the value of needle arthroscopy in human and veterinary joint disease.