Trivalent rare earth doped lasers in fluorozirconate glasses and fibers that lase between 2 and 3 μm are reviewed. There have been a large number of laser-fiber optic systems below 2pm developed for clinical microsurgery at a variety of sites. The required flexibility of the fiber optic waveguide varies with the clinical use, such as: intraocular (through a small diameter rigid tube), endoscopically accessible pulmonary and gastric mucosa (through a port of a fiber-optic endoscope of intermediate flexibility), and intra-arterial (as an integral part of a flexible catheter, which in the case of the coronaries must be very flexible so as to negotiate abrupt bends and bifurcations without damage to the vessels). Laser energy absorbed by tissue is capable of coagulation of tissue (denaturation of structural proteins), melting of fatty deposits or other structures (solid or gel to liquid phase transitions), as well as direct breakage of chemical bonds by high energy photons. It is of general interest to develop a pulsed laser system transmitted through flexible fiber optics that is capable of precise ablation of targeted tissue with minimal damage to the remaining tissue. Ideally, the device should be able to ablate any tissue because of the general absorptive properties of tissue, and not a specific chromophore such as melanin or hemoglobin, the concentration of which varies widely among tissues. Two obvious ubiquitous chromophores have been widely discussed: 1) proteins and nucleic acids whose high concentration and absorption coefficients lead to strong tissue absorption in the ultraviolet and 2) water whose strong infrared absorption bands have been widely utilized in CO2 laser surgery. Non-linear absorption occurring at very high power densities (~1 GW/cm2) has been shown to be very effective for non-invasive ocular (an optically transparent field) microsurgery at the image plane of a slit lamp, but this approach appears impractical in fiber optic systems because of similar non-linear damage mechanisms within the fiber.