Pictures are a pivotal element of our culture and emerge to be indispensible for most of society’s areas. This increasing importance is closely related to mediatization processes in our society. This paper deals with the mediatization process in the operating room and focuses on the implementation of pictures within this field. Using iconographic methods and empirical data (interviews, image analysis), this paper will show the developments from pure depictive pictures to digital images and further to (knowing) pictures (the latter leading to people's actions). We then will discuss some consequences of this comprehensive process on individual, social, cognitive-mental, and societal level.