Meibomian gland dysfunction is one of the most common causes of dry eye resulting in morphology changes to the meibomian glands. Meibography provides an in vivo means to assess the structure of the meibomian gland. Over the past 40 years, meibography has undergone significant development regarding its application to research and clinical practice. This review describes the evolution of the various meibography techniques, grading methods, and their diagnostic relevance.