Introduction Orbital decompression, as well as optic nerve decompression, are well known procedures that have been used frequently for a long period of time. As time goes by, techniques used for achieving orbital decompression continue to evolve; in the last ten years, changes appeared concerning decompression indications, incision made to gain access as well as for selection of the bone surface that is to be removed in order to gain decompression. Materials and Methods Whether there is an inflammation of the orbital soft tissues in Graves orbitopathy, a compressive optic neuropathy, severe corneal exposure, an orbital tumour that is compressing the optic nerve, orbital trauma with or without fracture, a complicated sinusitis with orbital determination or a cosmetic deformity, the incision and the bone decompression techniques used should be rigorously selected taking into consideration the risks and benefits of the intervention as well as the patients expectations and the surgeon's experience. Results Orbital bone decompression can be gained by using multiple surgical techniques depending on which wall of the orbit is to be decompressed. Thus, the procedure chosen could represent an external approach or a combined with endoscopy approach. Conclusions The aim of the paper is to look over the types of techniques used for orbital decompression and their development, throughout the years.