NOTES : Natural Orifice Transluminal Endoscopic Surgery, is a relatively new advancement of surgery and is still in its evolving state. Increasing interest in this surgery comes from the many advantages and better outcomes that it offers as compared to conventional open or other minimally invasive surgery. The book summarizes the evolution, concept, different types, complications, current status and the challenges of NOTES. We also report our results and experience with a new technique of pure transvesical NOTES, with a safe peritoneal entry and bladder closure.