This document discusses advanced index tuning techniques in SQL Server, including: - Using DMVs (dynamic management views) to passively tune indexes by observing performance and removing or adding indexes. - Active tuning techniques such as avoiding over-application of tuning wizard recommendations and giving indexes smart names for ongoing maintenance. - Using data compression for indexes in SQL Server 2008 to reduce storage requirements. - Addressing database fragmentation as a "silent performance killer" and using online reindexing techniques to defragment indexes without taking tables offline.