Background and Aims <p>Miscommunication can lead to patient harm, especially during surgical procedures. The World Health Organization Surgical Safety Checklist proves to be an effective tool to ensure patient surgical safety. The audit aims to identify loopholes in patient preparation and surgical safety and subsequently fix them using the Surgical Safety Checklist.</p> Methods and Material <p>s: This two cycle audit was carried out in the Department of ENT, Benazir Bhutto Hospital, Rawalpindi, using the WHO Surgical Safety Checklist with a little modifications in options to identify and fix loopholes in patient preparation and surgical safety. The audit consisted of 80 patients i.e. 40 patients in each group. Errors were seen in different domains in cycle 1 which were subsequently corrected in cycle 2 after educating staff and doctors.</p> Results <p>The audit revealed that the anesthesia machine was not functioning in 12.5% and the pulse oximeter wasn’t working in 10% of the patients in group A. After educating the staff, these errors were reduced to 0%. The allergy history was not documented in 12.5% of patients in cycle 1 but in cycle 2, the percentage dropped to 2.5%. Similarly, imaging was not displayed in the theatre in 17.5% of patients and correct instrument count was missed in 7.5% of patients in cycle 1 but miraculous improvement was seen in cycle 2.</p>