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Background: Endoscopic saphenous vein (SV) graft harvesting was introduced in the neurosurgical field as an attractive alternative to open SV graft harvesting. Methods: The left leg was draped, and the subcutaneous vein was identified by ultrasonography. The vein was harvested with use of the endoscopic Vasoview vessel harvesting system. Results: We performed six endoscopic SV graft harvest procedures for extracranial–intracranial bypass and autologous vein patch angioplasty for carotid artery stenosis. Conclusion: A high-quality graft was harvested with a good cosmetic outcome.