The introduction of arthroscopy of the temporomandibular joint represented a major change in the management of internal derangements and to the realization that re-establishing joint mobility by arthroscopic lysis and lavage was as effective as surgically restoring disc position. It was subsequently shown that such treatment could be done without joint visualization. This raised the question of whether the inability to visualize the joint and perform other surgical manipulations limited its usefulness. A comparison of the literature shows that although their effectiveness is essentially the same, arthrocentesis is simpler, has less morbidity, and has fewer complications than arthroscopic surgery.