PURPOSE: eXtended Reality (XR) technology, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), is a growing field in healthcare. Each modality offers unique benefits and drawbacks for medical education, simulation, and clinical care. We review current studies to understand how XR technology uses medical imaging to enhance surgical diagnostics, planning, and performance. We also highlight current limitations and future directions. APPROACH: We reviewed the literature on immersive XR technologies for surgical planning and intraoperative augmentation, excluding studies on telemedicine and 2D video-based training. We cited publications highlighting XR's advantages and limitations in these categories. RESULTS: A review of 556 papers on XR for medical imaging in surgery yielded 155 relevant papers reviewed utilizing the aid of chatGPT. XR technology may improve procedural times, reduce errors, and enhance surgical workflows. It aids in preoperative planning, surgical navigation, and real-time data integration, improving surgeon ergonomics and enabling remote collaboration. However, adoption faces challenges such as high costs, infrastructure needs, and regulatory hurdles. Despite these, XR shows significant potential in advancing surgical care. CONCLUSIONS: Immersive technologies in healthcare enhance visualization and understanding of medical conditions, promising better patient outcomes and innovative treatments but face adoption challenges such as cost, technological constraints, and regulatory hurdles. Addressing these requires strategic collaborations and improvements in image quality, hardware, integration, and training.