The need for precise targeted interactive surgery on boards or modules is the main driver of backside preparation technology. This article assists the analyst in making decisions on backside thinning and polishing requirements. Thinning of the substrates can be accomplished by flat lapping, laser assisted chemical etch, plasma reactive ion etch, and CNC based milling and polishing. The article discusses the general characteristics, key principles, advantages, and disadvantages of these processes. It also contains case studies that illustrate the application of these processes to ceramic cavity devices, injection molded parts, and ball grid arrays.