Abstract: A laser targeting device for use during surgical procedures provides means for the precise co-axial alignment of a narrow laser beam with an x-ray beam. The device has a case which contains a reflecting mirror mounted at 45.degree. on a low mass assembly. The mirror lies directly in front of a radio-opaque cruciform target. The case is adjustably mounted so that the image of the crosshair target may be accurately centered on the target head. A calibration aid is used to pinpoint the emanation point of the x-ray beam from the source cone of the image intensifier. The angle at which the laser beam strikes the mirror may be varied in two planes. When the crosshair image is centered and the laser beam is directed onto the emanation point the two beams are rendered precisely co-axial. Accurate drilling along the laser beam path without further recourse to x-ray screening is more accurate and eliminates direct exposure of the surgeon to irradiation during orthopedic procedures.