Abstract: Intraoperative optical coherence tomography (iOCT) enables real-time visualization of ocular structures during surgery and provides a dynamic view of the surgical process and instrument-tissue interactions to enhance our understanding of the surgical process, facilitate decision making at crucial steps of surgery, and optimize outcomes. At present, the applications of iOCT in anterior segment are continually expanding, whether hand-held or microscope integrated, and increasingly emerging as a useful adjunct in phacoemulsification, keratoplasty, glaucoma surgeries. It assumes both diagnostic and therapeutic importance in pediatric cases where pre-operative assessment is often not feasible. Otherwise，the applications of iOCT in refractive surgeries and ocular surface disorders is increasingly being evaluated. The limitations of present-day iOCT systems are related to instrument compatibility, automated tracking of the surgical field, and on-table volumetric analysis of the real-time images.(Int Rev Ophthalmol, 2020, 44： 306-312)