Reflection is an important learning technique for surgeons during their training and is a valuable tool for life-long learning and maintenance of certification to assure competency. Reflection helps individuals to evaluate their performance in the interest of improving their ability to deal with similar experiences in the future. Additionally, reflection can be helpful for established surgeons to continue to improve upon their performance and hone their craft. This article outlines the theoretical role of reflection in the learning process. We will discuss methods for incorporating reflection into training programs, and review the evidence for implementing reflection in surgical training.