BACKGROUND: Innovation in computer-assisted surgery (CAS) aims to increase operative accuracy and improve safety by decreasing procedure-related complications. The application of reality technologies, to CAS has begun to revolutionize orthopedic training and practice. METHODS: For this review, relevant published reports were found via searches of Medline (PubMed) data base using the following medical subject headings (MeSH) terms: "virtual reality" or "augmented reality" or "mixed reality" with "orthopedics" or "orthopedic surgery" and all relevant reports we utilized. RESULTS: Trainees now have authentic and highly interactive operative simulations without the need for supervision. The practicing orthopedic surgeon is better able to pre-operatively plan and intra-operatively navigate without the use of fluoroscopy, gain access to three-dimensional reconstructions of patient imaging, and remotely interact with colleagues located outside the operating room. CONCLUSION: This review provides a current and comprehensive examination of the reality technologies and their applications in Orthopedic surgery.