Improvements in the provision and outcomes of surgery and anaesthesia in low- and middle-income countries will be important in the ongoing task of improving population health and in meeting ambitious global expectations for achieving universal health care. Yet the requirements for complex training, resources and procedures are substantial. In a Guidelines and Guidance article, Justine Davies and colleagues discuss the development of updated indicators to support global achievement of access to safe surgical, anaesthetic, and obstetric care. Advocacy to support surgery and anaesthesia will be needed alongside the suggested indicators for measurement and reporting, addressing access to surgery, the surgical workforce, surgical volumes, and clinical and economic outcomes of surgery.

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