There are several notable pioneers in the history of surgery who paved the application of microsurgical techniques. In 1718, it was Jean Louis Petit who developed a screw-tourniquet mechanism that allowed complex surgical techniques to be applied with minimisation and prevention of blood loss. Later, Charles Louis Chevalier, in the 1840s, was first to construct a magnification loupe, which was followed by the development of the first simple loupe for surgical utilisation by Edwin Saemisch in 1876. These advances set the scene for the initiation of the microsurgical revolution. Initially, innovative surgeons, such as Jassinowski and Murphy, performed the first end-to-end vascular anastomoses. But in 1902, it was French surgeon and biologist, Alexis Carrel, who was the first to perform a vascular end-to-end anastomosis using a 3-stay suture / triangulation technique. It was for his technique in arterial anastomosis that Carrel was later awarded a Nobel Prize for medicine and physiology in 1912. It was not until later, in 1921, out of the University of Stockholm, a coined “father of microsurgery”, Carl-Olof Nylen, constructed the first surgical microscope. This led to the breakthrough achievement by Jacobson and Suarez in 1960 of successful microvascular anastomosis through use of an operating microscope. Acland, in the 1960s, then became a notable innovator in the development of microclamp and fine suture needle designs. These pioneers have made remarkable contributions to the history of surgery and the development of microsurgery, which now holds an extremely important place in modern reconstructive surgery.