Over the last dozen years several technologies have been developed to provide the spine surgeon with real-time information not available from the surgical exposure. The initial iterations of this technology involved matching anatomical points with previously captured radiographic information, such as computed tomographic scans. Although these techniques allowed more accurate placement of instrumentation, the mechanics of these devices often were cumbersome. More recent developments include the incorporation of the C-arm fluoroscope into the computer navigation system. This technique of virtual fluoroscopy allows the surgeon to navigate in several planes using preacquired fluoroscopic images while minimizing radiation exposure. The technique is relatively fast technique to learn and perform. Virtual fluoroscopy technique and its application to the lumbar and cervical spines are presented.