The Ultracision harmonic scalpel and laparosonic coagulating shears use high-frequency ultrasound energy and can be used as a substitute for electrosurgery, lasers and steel scalpels in both laparoscopic and conventional gynaecological surgery. Its unique mechanism of action allows cutting and coagulation without causing a significant rise in temperature at the tissue level. Its safety has been tested extensively in animal experiments and there is now ample evidence to suggest that it produces less thermal damage in vitro compared to electrosurgery and lasers. Although these results have been extrapolated to human beings, there are no in vivo studies in humans to corroborate the above observations. This review highlights the mechanism of action, tissue effects, safety aspects, applications, versatility and limitations of this novel technique. The many advantages demonstrated by this instrument over other energy sources used in laparoscopic surgery should make it more popular in forthcoming years.