Advancements in both optical coherence tomography (OCT) and near infrared autofluorescence (NIRAF) are ushering in a new advantageous approach to parathyroid gland identification, and in appropriate settings parathyroid gland preservation, in head and neck surgery. The participant in this expert lecture should benefit from an understanding of the status of development and usage of these nascent technologies as well as the current possible algorithms and barriers for implementation.