The Civil War was fought across more than 10,000 battle sites and is regarding as an extremely dark period of American History. Over 2% of the US population died in the conflict, with estimated fatalities ranging from 620,000-752,000 (1). Surgical care during the conflict is commonly viewed as being rudimentary at best and barbaric at worst, the conflict being somewhat unfairly known for surgery without anaesthesia and vast numbers of unnecessary amputations. Although the conflict did indeed lead to large numbers of disabled veterans, this was largely due to high numbers of non-fatal extremity injuries inflicted by the low velocity muskets that were used by combatants, rather than a lack of skill by the treating surgeons. Indeed, only the most senior of the Union surgeons were allowed to amputate. During the year after the war ended, the state of Mississippi spent 20% of its budget on artificial limbs for veterans (2). The surgeons were practicising in an era before germ theory was established, before sterile techniques and antisepsis were known, with very few effective medications, and often operating for 48-72 hours without sleep. Despite this, many advances were made by dedicated clinicians on both sides of the conflict, including public health measures, disease prevention, medical evacuation, creation of specialty hospitals, safe use of anaesthesia, performance of rudimentary Neurosurgery, development of techniques of arterial ligation and the first performance of plastic surgery.. 1. Hacker JD. A census-based count of civil War dead. Civ War Hist. 2011;57:307-348 2. Foote S. The Civil War: A Narrative. Vol. 3. New York: Random House;1958. Pp 1040-1041