Surgical research has previously been derided for low quality and lack of impact. In the last twenty years this has been revolutionised in the UK. Together, the Royal College of Surgeons of England and the National Institute of Health and Care Research, provide an infrastructure for research in England and Wales which is truly world leading. But challenges remain in surgical research to match the pace and scale of surgical innovation - safely providing access for our patients to cutting edge health technologies and bringing life science and biotech investment into the UK economy. Individual research studies, major registries and future national outcome and registry programmes will provide opportunities to accelerate surgical research in the UK.