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Endoscopic ultrasound (EUS) has come a long way in the field of interventional gastroenterology. Majority of the advancements in the field of EUS over the past 20 years has been done by the group of endoscopist who are looking to break the convention. At this time both diagnostic and interventional EUS has become the standard of care in the management of large number pancreatic, biliary, luminal gastro-intestinal, and mediastinal diseases. It is now widely available as the large number of medical institutions, have added it to their endoscopic armamentarium. Scope of interventional EUS in clinical practice is rapidly expanding. Here in the current review, we highlight the key concepts of various interventional EUS procedures like-EUS guided drainage of pancreatic fluid collection; EUS guided vascular therapy; EUS guided enteral anastomosis; EUS guided biliary drainage; Role of EUS in hepatology; EUS guided celiac plexus neurolysis and neurolysis. We also discuss the indications, technical aspects, adverse events, and future directions of each of these procedures. If looking into future, we can predict an evolution of these techniques into an exciting newer horizon in the form of EUS-guided minimally invasive surgery.