Laser tissue welding as well as other alternative methods of closure will play a more important role in surgical specialties as laparoscopic, endoscopic, and microsurgical techniques continue to develop. Laser tissue welding uses laser energy to anastomose tissues and is ideally suited for applications in which suturing and stapling is difficult. Recent advances have led to a better understanding of the mechanisms of tissue welding. Additionally, technical achievements including the introduction of protein solders and temperature-controlled feedback systems have led to the acceptance of laser tissue welding in clinical medicine. In this article, we describe the history and development of laser tissue welding and review the current and potential applications of this technology.