Endoscopic surgical techniques were employed in 5 patients to harvest the sural nerve atraumatically with a minimal number of skin incisions. The medial sural nerve was harvested by two 2-cm-wide transverse incisions made under endoscopic-magnified visualization, which allowed the surgeon to see the detailed structure of the nerve and surrounding tissue. This method requires minimal traction of the nerve during nerve dissection, and postoperative pain and swelling were less than encountered with conventional methods, because the method we have employed is less invasive and atraumatic.