Purpose of Review <p>Frugal innovations prioritize low-cost interventions, while keeping in mind efficacy, accessibility and scalability. Despite a scientific culture that often celebrates major financial investment and cutting-edge technologies, frugal innovations can be just as important in both low-income countries where resources are scarce as they are high income countries where the health needs of aging populations may be outpacing economic growth. We sought to comprehensively review the current state of frugal innovations in orthopaedic surgery, as well as to identify next steps as the importance of these low-cost interventions continues to grow.</p> Recent Findings <p>Frugal innovation is particularly relevant in orthopaedic care as musculoskeletal interventions such as prosthetics, orthotics and surgery demand significant materials, skilled labor, and frequent follow-up. There have been numerous innovations in the recent years, including the development of low-cost intramedullary nails, bioabsorbable implants, negative-pressure wound therapy systems made from aquarium pumps, repurposed Foley catheters and nasogastric tubes for use in surgeries, among many more.</p> Summary <p>Frugal innovations in orthopaedic surgery are becoming more relevant and rapidly evolving in all health-care settings as a tool to deliver value-based care to the growing needs of the population. Though many of these projects are performed on a local scale, when considered collectively, they demonstrate powerful efforts to move the needle in enhancing access to high-quality orthopaedic surgical care and reduce the burden of global musculoskeletal disability. Frugal innovations offer immense promise in reducing costs and closing the gap of access to high-quality orthopaedic care worldwide</p>