This chapter, Ethical Challenges in the Rise of Artificial Intelligence by Hinojosa and Bobadilla-Rosado, examines how artificial intelligence (AI) is transforming surgery, decision-making, and patient relationships. From image-guided procedures to predictive analytics during intraoperative decisions, AI provides valuable support. However, the speed of AI’s integration outstrips our efforts to reflect on its ethical implications, many of which are more than speculative and already evident in current surgical routines. Surgeons face the challenge of seeking informed consent from patients who might not fully grasp the role of AI in their care. Relevant issues also include the relative liability of surgeons vs artificial intelligence and the protection of sensitive patient data. The chapter discusses the risks that AI could widen inequalities between well-resourced and poorly resourced surgical units, limiting access for already underserved patient populations. Finally, the authors call for a transition from theoretical debates about education to systematic interdisciplinary training, with robust institutional support and participation from surgeons, ethicists, lawyers, and patients.