PURPOSE: Optical pose tracking of medical instruments is often used in image-guided interventions. Unfortunately, compared to commonly used computing devices, optical trackers tend to be large, heavy, and expensive devices. Compact 3D vision systems, such as Intel RealSense cameras can capture 3D pose information at several magnitudes lower cost, size, and weight. We propose to use Intel SR300 device for applications where it is not practical or feasible to use conventional trackers and limited range and tracking accuracy is acceptable. We also put forward a vertebral level localization application utilizing the SR300 to reduce risk of wrong-level surgery. METHODS: The SR300 was utilized as an object tracker by extending the PLUS toolkit to support data collection from RealSense cameras. Accuracy of the camera was tested by comparing to a high-accuracy optical tracker. CT images of a lumbar spine phantom were obtained and used to create a 3D model in 3D Slicer. The SR300 was used to obtain a surface model of the phantom. Markers were attached to the phantom and a pointer and tracked using Intel RealSense SDK’s built-in object tracking feature. 3D Slicer was used to align CT image with phantom using landmark registration and display the CT image overlaid on the optical image. RESULTS: Accuracy of the camera yielded a median position error of 3.3mm (95th percentile 6.7mm) and orientation error of 1.6° (95th percentile 4.3°) in a 20x16x10cm workspace, constantly maintaining proper marker orientation. The model and surface correctly aligned demonstrating the vertebral level localization application. CONCLUSION: The SR300 may be usable for pose tracking in medical procedures where limited accuracy is acceptable. Initial results suggest the SR300 is suitable for vertebral level localization.