<p>This article reviews current Human Factors concepts in Trauma and Orthopedic surgery including decision making, interventions, and safety culture.Trauma and Orthopaedic surgery is a high-risk specialty, consistently appearing in the top five specialties for clinical negligence claims. Surgeons often work in a highly-complex environment where challenging decision making takes place in an imperfect work setting. Human factors (HF) is the study of the systems in which we work, how we interact with technology (ergonomics) and each other. Application of HF in surgery can lead to improved patient safety, efficient team working, and higher staff morale. A positive clinical environment, team, organisation and regulator safety culture are all vital to allow HF interventions in healthcare to be created and implemented effectively.</p>