Nailfold videocapillaroscopy (NVC) is a non-invasive technique that enables the evaluation of peripheral microcirculation by visualising nailfold capillaries. Although traditionally used in systemic sclerosis, NVC may also be useful in other systemic autoimmune rheumatic diseases, and particularly idiopathic inflammatory myopathies (IIMs). This review aims to summarise the current evidence on the prevalence of NVC findings in IIMs and their correlation with clinical and serological characteristics, as well as diagnostic, follow-up, and prognostic implications.