Recent studies using universal cystoscopy have demonstrated a higher rate of urinary tract injury at major gynaecological procedures than previously thought. These injuries are associated with significant medical and medico‐legal implications. The sensitivity of visual inspection is low and cystoscopic screening with intravenous dye improves detection. We review the evidence for intra‐operative cystoscopy in gynaecology, with emphasis on rates of urinary tract injury and the use of intravenous contrast dye.