This video depicts the utility of microscope-integrated intraoperative optical coherence tomography (iOCT) in various vitreoretinal pathologies. iOCT is a novel technology whose clinical utility is still being explored in various ophthalmic pathologies requiring surgical management. This video covers the spectrum of utility of iOCT in various vitreoretinal pathologies (i.e., macular hole surgery with internal limiting membrane tucking or autologous neurosensory retinal graft, subretinal tissue plasminogen activator injection, optic disc pit, proliferative diabetic retinopathy sequelae, scleral buckling, etc.). This video shows the role of iOCT as (a) an alternative to a surgical adjuvant such as triamcinolone and dye, (b) a surgical endpoint guide, (c) an informative tool necessitating additional surgical maneuvering, especially in macular surgeries and (d) a diagnostic tool in pediatric patients. iOCT can be performed in pediatric cases, while doing examination under anesthesia; it can serve as a noninvasive tool where the retina is endoilluminated externally, allowing visualization of the retina and successful image acquisition.