Miniaturized endoscopy has advanced accurate visual perception within the human body. Prevailing research remains limited to conventional cameras employing convex lenses, where the physical constraints with millimetre-scale thickness impose serious impediments on the micro-level clinical. Recently, with the emergence of meta-optics, ultra-micro imaging based on metalenses (micron-scale) has garnered great attention, serving as a promising solution. However, due to the physical difference of metalens, there is a large gap in data acquisition and algorithm research. In light of this, we aim to bridge this unexplored gap, advancing the novel metalens endoscopy. First, we establish datasets for metalens endoscopy and conduct preliminary optical simulation, identifying two derived optical issues that physically adhere to strong optical priors. Second, we propose MetaScope, a novel optics-driven neural network tailored for metalens endoscopy driven by physical optics. MetaScope comprises two novel designs: Optics-informed Intensity Adjustment (OIA), rectifying intensity decay by learning optical embeddings, and Optics-informed Chromatic Correction (OCC), mitigating chromatic aberration by learning spatial deformations informed by learned Point Spread Function (PSF) distributions. To enhance joint learning, we deploy a gradient-guided distillation to adaptively transfer knowledge from the foundational model. Extensive experiments demonstrate that our method surpasses state-of-the-art methods in metalens segmentation and restoration by a large margin. Data, codes, and models will be made publicly available.