Photovoice, a popular method in qualitative participatory research, involves individuals taking photographic images to document and reflect on issues significant to them. Having emerged in the mid-1990s, its popularity has been related to several advantages of working with the method associated with enhanced forms of expression and accessibility, as well as a strong alignment with participatory research principles. We explore the advantages, challenges and opportunities in working with photovoice in qualitative research through gleaning insights from the literature and from studies that were part of IN’¢GAUGE®, a research program that has used photovoice and other visual methods for doing research with youth and families for over 15 years. The insights provide guidance for the evolution of photovoice and the development of ethical protocol assessments that are necessary for enhancing the participatory and empowering aspects of photovoice.