Since the beginning of the century there has been a trend towards performing major surgeries on the out-patient basis. The first properly organized major out-patient operations were, however, performed on non-hospitalized patients using a local, general of conductional anesthesia in the USA in 1960. Since then special surgical and anesthesiological technical units have been organized together with fully independent surgical centres in order to perform major operations using out-patient facilities. Thirty years of experience of major operations being performed on hundreds of out-patients have shown that this is better, simpler, more attractive and cheaper than performing the same operations on hospitalized patients in hospitals, with great satisfaction shown by patients, their families, health care workers and society. The realization of the above goal requires special new programmes, plans and facilities since existing hospital programmes are incompatible with the project.