The small scale of microsurgery poses significant challenges for developing robust and dexterous tools to grip, cut, and join sub-millimeter structures such as vessels and nerves. The main limitation is that traditional manufacturing techniques are not optimized to create smart, articulating structures in the 0.1–10 mm scale. Pop-up book MEMS is a new fabrication technology that promises to overcome this challenge and enable the monolithic fabrication of complex, articulated structures with an extensive catalog of materials, embedded electrical components, and automated assembly with feature sizes down to 20 microns. In this paper, we demonstrate a proof-of-concept microsurgical gripper and evaluate its performance at the component and device level to characterize its strength and robustness. 1-DOF Flexible hinge joints that constrain motion and allow for out-of-plane actuation were found to resist torsional loads of 22.8±2.15 N·mm per mm of hinge width. Adhesive lap joints that join individual layers in the laminate structure demonstrated a shear strength of 26.8±0.53 N/mm2. The laminate structures were also shown to resist peel loads of 0.72±0.10 N/mm2. Various flexible hinge and adhesive lap components were then designed into an 11-layered structure which ‘pops up’ to realize an articulating microsurgical gripper that includes a cable-driven mechanism for gripping actuation and a flexural return spring to passively open the gripper. The gripper prototype, with final weight of 200 mg, overall footprint of 18 mm by 7.5 mm, and features as small as 200 microns, is able to deftly manipulate objects 100 times is own weight at the required scale, thus demonstrating its potential for use in microsurgery.