Review of leading medical and surgical journals shows that the most frequent area of publication is papers with a genetic or molecular biology component. Some of these papers will involve childhood or prenatal diagnostic issues, while an increasing proportion involve adult-onset single disorders such as neurological disease or familial cancers. In the future, complex multifactorial (or polygenic) diseases such as cardiovascular and respiratory diseases will become more prevalent, and already the ethical issues involved are complex and widely discussed. Surgeons need to know about genetics and how it interacts with modern surgical practice. Inherited diseases contribute to a substantial proportion of the surgical workload. Recognition of a positive history of disease in a family will allow genetic testing and precise diagnosis, leading to the ability to presymptomatically screen at-risk members of a family and allow screening and prevention strategies to be implemented.