If one adds a digital three-chip camera and a digital VCR, or fully computerized digital equipment, detailed, precise frame-by-frame and slow-motion images reveal subtle elements of pathology of phonation and deglutition that cannot be appreciated by the human eye in real-time evaluations. The human eye can perceive just five different images per second. The National Television Systems Committee video format used in the United States allows 30 frames per second to be studied. With digital techniques, each frame identifies sharp, clear images of the vocal fold edge and fine details of laryngeal activity, including mucosal abnormalities and opening and closing patterns. Shape, movement, vibratory patterns, time relationships between opening and closing of vocal folds, and maximum opening and closure of vocal folds are observed. Routine use of videotape recording is required for documentation of changes resulting from treatment; enhancement of teaching to patients, families, professionals, and students; archival record keeping; a means for more than one specialist to view the procedure at the same time; a means for repeated observation of the same event repeatedly and definitively; quantitative and qualitative visual explanations of the data and disorders; and a means for visual feedback training. FEES without videotape recording relies on subjective interpretation and documentation, thereby diminishing the validity and reliability of conclusions. All sports fans know that the instant replay has revolutionized the way that we watch sports and the way in which they are judged. Should anything less precise be offered to our patients? Within the next year or two, inclusion of videotape recording for FEES, FEESST and strobovideolaryngoscopy procedures will be mandated by the Center for Medicare and Medicaid Services.