Purpose: Japanfs Endoscopic Surgical Skill Qualification System (ESSQS) is an external, video-based credential intended to standardise minimally invasive surgical technique. We summarised published evidence on ESSQS assessment properties and clinical utility. Methods: Narrative review of PubMed-indexed literature and citation hand-searching. Eligible studies described ESSQS processes (unedited video submission, scoring, inter-rater agreement) and/or compared perioperative outcomes by ESSQS-certified surgeon involvement. Results: ESSQS uses independent review of an unedited operative video by two judges, with adjudication when discordant. In gastric surgery (2004–2009), 154/345 (44.6%) applicants were accredited and inter-rater agreement ranged 0.21–0.59. A five-year gastrointestinal report (n=1369) found lower complication rates for successful versus failed applicants (4.3% vs 5.6%, p=0.0096). In a National Clinical Database analysis (2014–2016), ESSQS certification was associated with lower odds of anastomotic leakage after laparoscopic distal gastrectomy (OR 0.835; 95% CI 0.723–0.964) and favourable trends after laparoscopic low anterior resection. In a multicentre rectal cancer cohort (EnSSURE; 2014–2016), propensity score–matched analyses showed shorter operative time and lower conversion to open surgery when ESSQS-certified surgeons operated. Conclusion: Evidence supports ESSQS as a structured, scalable approach to external video-based credentialing with consistent signals toward improved short-term outcomes. Limitations include heterogeneity and residual confounding; prospective, registry-linked evaluations are needed to define optimal integration with training pathways.