A team approach is essential to the practice of successful surgery. Good surgery begins before any incision is made with consideration of the type of equipment needed and the incision to be used to ensure optimum access. Although the repertoire of tools available to the surgeon has increased, the attainment of safe and efficient surgical technique still depends on a comprehensive knowledge of the basic surgical skills outlined in this chapter. These include proficiency in knot tying, instrument handling, suturing, haemostasis and tissue dissection. Surgery should 'flow', using the simplest and safest way to achieve the operative goal. As the duration of training shortens, the importance of teaching good surgical technique by example and direct supervision has never been greater.