The 3 H 4 → 3 H 5 transition of Thulium ions (Tm 3+), which features laser emission at ~2.3 µm is studied in details. We revise the conditions for efficient laser operation using a rateequation model accounting for the ground-state bleaching, crossrelaxation and energy-transfer upconversion (ETU). We show that ETU has a crucial role in reaching more than unity pump quantum efficiency (QY) for ~2.3 µm Tm lasers based on highlydoped crystals. A Ti:Sapphire pumped quasi-continuous-wave 3.5 at.% Tm:LiYF 4 laser generated 0.73 W at 2306 nm with a record-high slope efficiency of 47.3% (versus the absorbed pump power) featuring a QY of 1.27. Diode-pumping of this crystal yielded a peak output power of >2 W. The first 2.3 µm Tm waveguide laser is also reported based on Tm:LiYF 4 epitaxial layers with even higher doping of 6.2 at.% generating 0.23 W with a slope efficiency of 19.8%. The spectroscopic properties of Tm:LiYF 4 relevant for the ~2.3 µm laser operation are revised as well.