INTRODUCTION: Computer aided navigation is an important tool which has the capability to enhance surgical accuracy, while reducing negative outcomes. However, it is a relatively new technology and has not yet been accepted as the standard of care in all settings. OBJECTIVES: The objective of the present study is to present the development and current state of technologies in computer aided navigation in Orthopedic Spine Surgery, specifically in navigated placement of pedicle screws, to examine the clinical need for navigation, it's effect on surgical accuracy and clinical outcome and to determine whether the benefits justify the costs, and make recommendations for future use and enhancements. CONCLUSION: Computer aided navigation in pedicle screw placement enhances accuracy, reduces the probability of negative outcomes, reduces the exposure of the patient and staff to radiation, reduces operative time, and provides cost-savings. Future investigations may potentially enhance this effect further with the use of innovative augmented reality type displays.