Most surgeons conceptualize "surgical advance" as the introduction of a new operative technique or the presentation of a technologic breakthrough. However, the true landmark innovations of the past decade, with regard to effecting surgical health care delivery, have been the impact of economics and sociology in determining the profession's future. In the past, the surgeon's primary interests revolved around the art and science of surgery, and socioeconomic issues were deemed of secondary importance. Consequently, few of the investigations into "surgical socioeconomics" were conducted by surgeons, and the surgical establishment was more than mildly apathetic toward such social science research. All of this has changed, and it is now evident that there is an overwhelming need for surgeons to incorporate an understanding of sociologic and economic conditions into their clinical thinking. Basic tenets of surgical socioeconomics are presented, and their impact on various clinical situations is discussed.