Purpose <p>Although the American Board of Surgery established 18 core general surgery entrustable professional activities (EPAs), procedures not included in the core list (non-core EPAs) comprise a substantial portion of residents’ case volumes at quaternary referral centers. Comparing core and non-core EPAs may help to better characterize resident progression and preparation for fellowship training.</p> Methods <p>We retrospectively analyzed EPA assessment data from a large quaternary referral center. Faculty completed assessments for the 18 core EPAs and used a “non-core” category for procedures not included in that list. Assessments were stratified by postgraduate year (PGY) to assess completion across training levels. A mixed-effects linear regression model compared entrustment-supervision (ES) scores (1 = observation to 4 = practice ready) between core and non-core assessments, accounting for individual resident performance.</p> Results <p>Between June 2022 and July 2024, we collected 1135 core and 558 non-core EPA assessments. Senior residents completed more non-core EPA assessments, with PGY5 residents completing the most (PGY1: 43; PGY2: 141; PGY3: 115; PGY4: 64; PGY5: 235).The most common non-core procedures were pancreatectomy (<i>n</i> = 74), gastrectomy (<i>n</i> = 67), ostomy reversal (<i>n</i> = 60), pediatric central line (<i>n</i> = 52), and hepatectomy (<i>n</i> = 45). Mixed-effects modeling showed that ES scores were significantly higher for core EPAs (<i>F</i> = 9.37, <i>p</i> &lt; 0.01). PGY level significantly predicted ES scores (<i>F</i> = 279.45, <i>p</i> &lt; 0.001), and only a small proportion of score variability (variance = 0.05) was attributable to resident differences.</p> Conclusions <p>Non-core EPAs reflect complex operations with lower entrustment levels. Non-core EPAs provide clarity on the progression of entrustment as case complexity increases. Incorporating non-core EPA assessments may enhance assessment of senior residents.</p>