Narrow band imaging (NBI) is a novel method of imaging that increases the diagnostic potential of conventional endoscopy. It highlights abnormalities in the superficial vasculature of mucosal lesions so that precancerous or cancerous lesions can be identified more easily. Initially developed for the gastrointestinal tract, and widely used in other branches of medicine, it is now being used for the assessment of patients with malignancy in the head and neck. We review current published papers relating to NBI and discuss its benefits for early detection of cancer of the head and neck.