There are certain surgical procedures that owing to their magnitude should always be done in the hospital. There are many minor procedures that can routinely be done in the surgeon's office, emergency room or the OPD under local anaesthesia with immediate discharge of the patient. Between these two ends of the surgical spectrum are a large number of procedures that in the appropriate patients and under proper circumstances and conditions can be done as major ambulatory surgery (MAS). It is the surgeon's obligation and responsibility in concurrence with the patient to make this decision. Nearly 60% of the surgical procedures are expected to be performed in an ambulatory setting. Major ambulatory surgery has thus become an accepted modality of delivery of surgical care, wherein all the participants (Patient, Dr., Management) gets benefitted and hence it has steadily grown in availability and utilization.