Purpose <p>Leadership skills are critical for success as a surgical trainee and attending. However, the prevalence of structured leadership training curricula in surgical residency training programs is unknown. The objective of this study was to assess the current state of the literature in terms of reporting on formal leadership curricula in surgical residency programs in the United States.</p> Methods <p>A systematic literature search was performed per PRISMA guidelines. Inclusion criteria consisted of all original research articles that discussed the implementation of a formal surgical leadership curriculum in ACGME-accredited residency programs. Exclusion criteria included non-surgical residencies, leadership training for medical students or faculty and non-U.S.-based residency programs.</p> Results <p>A total of 199 studies underwent screening. Ten studies (5.0%) met final inclusion criteria, published from 2004 to 2024. A total of 252 residents were included across eight studies (2/10 studies did not disclose how many residents participated). The most common forms of curricular intervention were formal leadership lectures (including free-standing lectures and leadership-focused grand rounds speakers), journal clubs, and individualized leadership mentoring/coaching. Seven of the 10 formal leadership programs (70%) were modelled according to literature, programs, or experts in other industries. Curricular impact was measured via faculty feedback, rates of attrition, and surveys/feedback from the residents following the intervention.</p> Conclusions <p>The prevalence of literature describing formal leadership curricula in U.S. residency programs is sparse. However, those surgical residencies that have described the implementation of such programming have largely reported success and positive reactions from participants.</p>