The evolution of stapes surgery for otosclerosis has undergone several advancements to reach its current form. Although the microscopic approach to stapes surgery is still the current treatment standard for otosclerosis, endoscopic stapedectomy is a relatively new approach that has been gaining traction as a minimally invasive option. Endoscopic stapedectomy includes several important steps including incudostapedial joint separation, downfracture and removal of the stapes suprastructures, and prosthesis placement. These steps require a high level of technical skill and present a steep learning curve. However, this approach includes several technical advantages to decrease morbidity and support patient outcomes. Here, we present the endoscopic approach to repair otosclerosis and ultimately improve conductive hearing loss.