Until the end of the nineteenth century, surgery on the abdominal organs, particularly the intestines, was very limited as it represented a risky and often deadly procedure. Although this chapter summarises advances in abdominal surgery from ancient times to the nineteenth century, its focus is on the introduction of modern abdominal and gastrointestinal surgery through the late nineteenth and twentieth centuries. Ambroise Paré’s management of abdominal and intestinal wounds, Louis XIV's anal fistula, a history of the appendix and appendicectomy open the chapter before a more detailed coverage of the history of laparotomy and intestinal suturing. Milestones in the development of rectal, colonic and gastroduodenal surgery are then discussed with a brief coverage of the pioneers. The chapter follows with accounts of the history of surgery on the liver and pancreas and concludes with a section on the development of endoscopy over the last two centuries. There is a section on thyroid and parathyroid surgery at the end.