[Object] To provide a medical observation apparatus and a medical observation system that can ensure the user's visual field and have good manipulability. [Solution] A medical observation apparatus includes: a cylindrical unit; an imaging unit provided in a hollow portion of the cylindrical unit and including an optical system configured to collect light from an object to be observed and form an image, and an imaging element configured to photoelectrically convert light collected by the optical system and output an imaging signal; a support unit including at least one set composed of two arm units and a joint unit linking one of the two arm units to the other in a rotationally movable manner and supporting, at its tip portion, the cylindrical unit and the imaging unit in a rotationally movable manner around an axis in a height direction of the cylindrical unit; and an arm manipulation unit provided on a side surface of the cylindrical unit corresponding to an upper side of an image based on the imaging signal and configured to accept a manipulation input that permits a rotational movement of the arm unit.