An aiming and status indicator system for surgical lightheads, cameras, and other lighting system accessory devices. The system includes a plurality of marker lights mounted to a housing for the accessory device. Each marker light produces a respective marker light beam that is directed towards a work area (surgical site) to provide a marker indicator pattern. The marker indicator patterns can be used to indicate the boresight of a lighthead or camera, whether a lighthead is in a focused or unfocused condition, and status information associated with the lighting system.