With the development of near-infrared (NIR) technology, real-time utility of NIR and its fluorophores has gained vast interest among surgeons of various sub-disciplines. The purpose of this review is to assess and explore the most recent developments in NIR-guided surgery in an upper gastrointestinal (UGI) surgical setting. Queries of PubMed and Medline literature databases was performed for experimental and clinical studies relevant to NIR use in the context of UGI surgery. NIR-guided UGI surgeries have been reported to be valuable in: (1) esophageal anastomosis; (2) sentinel lymph node biopsy in gastric cancer; (3) detection of liver and pancreatic tumors; and (4) detection of extra bile duct and bile duct injuries. Although NIR technology has shown tremendous promise in UGI surgery, its full clinical translation and wider adaptation remains to be seen. Copyright © 2013 John Wiley & Sons, Ltd.