Background. Although penetrating keratoplasty remains the gold standard for surgically treating corneal endothelial pathologies, tremendous progress has been made in recent years to improve the technology of (posterior) lamellar keratoplasty. Methods. Literature review from PubMed and own data. Results. Posterior lamellar keratoplasty using a microkeratome (Descemet's stripping with automated endothelial keratoplasty, or DSAEK) is a reliable surgical technique for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy. Visual rehabilitation is faster with lamellar keratoplasty than penetrating keratoplasty. Conclusion. Posterior lamellar keratoplasty techniques such as DSAEK will become an important surgical treatment option for corneal endothelial pathologies.