Vaginoscopy is endoscopic inspection of the vagina. The vaginoscopic or ‘no touch’ approach to hysteroscopy is a technique that obviates the use of unnecessary instrumentation of the lower genital tract, which is especially germane in the conscious outpatient because it is associated with less pain. Visualisation of the external genitalia should form part of hysteroscopic examination. However, routine placement of a vaginal speculum is unnecessary to visualise the cervix if a hysteroscopy is performed because an excellent view is obtained endoscopically. Bimanual examination, however, should be performed at the discretion of the operator and is mandatory if abnormality is suspected.