This text is organized by organ system and the illustrations highlight surgical pearls borne of experience and polished by the study of pertinent references. Hand-drawn and illustrated figures show exact anatomical relationships as we see them in-vivo. A question/answer format augments the images to allow the reader to actively reflect on the topic and to appraise his/her knowledge in that area. The discussion sections strive to explain not only what the correct answer is, but also why the distractors are wrong, in order to motivate discussion and self-reflection. Cognitive Pearls in General Surgery details the explicit thought processes and associations that underlie the understanding of the topics at hand, with the intent of enhancing the fun and enjoyment that only an informed and well-grounded practice of surgery can provide.