In this issue of Surgical Clinics, guest editor Dr. Benjamin D. Shogan brings his considerable expertise to the topic of The Surgical Microbiome. Recent evidence highlights the sensitivity of gut microbiota to antibiotics, bowel preparation, and surgery. In this issue, top experts provide an introductory article on preparing the microbiome for surgery, followed by specific articles on the microbiome and colorectal cancer, pancreatic cancer, bariatric surgery, inflammatory bowel disease, diverticulitis, vascular disease, and neurosurgery.