Purpose Emergency laparotomy (EL) is a common procedure that general surgeons are called upon to undertake on a heterogenous patient population with varying pathology and corresponding heterogenous outcomes. Various scoring tools have been developed to quantify a patient’s risk of mortality after EL but uptake of these tools is poor. We aimed to characterise attitudes of general surgeons and junior doctors working in general surgery to risk assessment tools, barriers to their use and potential strategies for improvement. Methodology This qualitative study used a mixture of face to face, online and telephone semi-structured interviews. Participants were recruited with a snowball purposive sampling approach. Interviews were transcribed and then coded using Framework Method to identify key themes. Results Fifteen general surgeons, registrars and residents were interviewed. Various current risk assessment practices existed amongst participants. Barriers identified included perceived lack of utility, competing priorities, unit or hospital culture, individual surgeon attitudes, lack of funding, JMO turnover and lack of familiarity. Potential strategies for improvement identified included education, integration with electronic health records, prompting at time of theatre booking. Conclusion Our findings will be of interest to those undertaking quality improvement work with risk assessment for EL. This is particularly important given the recommendation from NELA and ANZELA for universal risk assessment but the low uptake of risk assessment in practice.