Numerous American volunteer organizations travel throughout the developing world, providing surgical services to those in need. Medical staff who undertake such missions must contend with the realities inherent to providing healthcare abroad. Inadequate medical facilities and equipment, coupled with a short mission duration and the lack of substantial integration with the local medical community, greatly increase the risk of unnecessary medical complications. At present, there is no definitive set of quality assurance guidelines for the surgical outreach community. This report draws on 20 years of outreach experience to recommend a set of quality assurance guidelines for surgical outreach missions.