A high-efficiency, wide-angle illumination surgical system is disclosed, one embodiment comprising: a light source for providing a light beam; an optical cable, optically coupled to the light source for receiving and transmitting the light beam; a handpiece, operably coupled to the optical cable; an optical fiber, operably coupled to the handpiece, wherein the optical fiber is optically coupled to the optical cable to receive and transmit the light beam; an optical element, optically coupled to a distal end of the optical fiber, for receiving the light beam and scattering the light beam to illuminate an area, wherein the optical element comprises a compound parabolic concentrator ("CPC") cone; and a cannula, operably coupled to the handpiece, for housing and directing the optical fiber and the optical element. The optical element can be a small-gauge, diffusive optical element comprising a sculpted distal end of the optical fiber or a machined or injection-molded plastic CPC-cone. For example, the optical element can be a 19, 20 or 25 gauge optical element. The CPC-cone optical element angularly spreads the light beam out to a high off-axis angle and emits the light out of the distal end of the cannula with high efficiency.