The art and science of surgery is rapidly advancing year by year. Newer techniques and instruments are being added every year, and emphasis is on zero-error surgery. We are bringing the fourth edition of this book. The present edition is an attempt to provide far insight of recent advances. Many chapters such as “Informed Consent, Enhanced Recovery After Surgery, WHO Safety Checklist, Wrong-site Surgery, and Duty of Candor” have been added for the first time. It is a humble effort to cultivate culture of surgical safety. Many chapters, such as General Surgical Instruments, Principles of Robotic Surgery, Basic Surgical Procedures, and Basics of Staplers have been thoroughly revised and updated. All the diagrams have been redrawn to make them more simplified. With the fourth edition, which has taken an altogether different shape, we hope to enrich the readers with knowledge. We thank the readers for the feedback and support and look forward to constructive criticism.