This chapter, Ethical Challenges in Crisis and Epidemic Response by Carlos A. Hinojosa and Luis O. Bobadilla-Rosado, examines the ethical challenges surgeons encounter during health crises and epidemic response, when urgency, fairness, and safety must be balanced against resource constraints. The chapter addresses not only logistical hurdles but also the deeply human decisions and physical toll on the surgical team involved. During the COVID-19 pandemic, surgeons confronted scenarios no protocol had fully anticipated. Elective surgeries were postponed by 70%, and critical resources, operating rooms, ventilators, and staff were in short supply. Rapid decisions had to be made under pressure, often without clear guidance. In this context, fairness and transparency have become essential, not just for patient outcomes but also for sustaining trust in institutions and public health systems. The authors also highlight a key oversight in many ethical frameworks: the neglect of the mental and emotional well-being of healthcare workers. The strain on providers exposed the need for more inclusive ethical planning. They argue for practical response models that support ethical and resilient care in future crises, safeguarding both patients and providers.