The basic aims of good theatre design and practice are to create a flexible work space, efficient work flow and as clean an environment as possible to minimize contamination of the surgical patient. Minimizing patient contamination will, in turn, reduce the number of surgical infections. Surgical infections have significant cost to the patient, owner and practice. Although surgical infections will occur in even the best designed and managed theatres, a good understanding of basic principles of design and management will keep them to a minimum. The chapter covers the following: Surgical facility design; Personnel and responsibilities and Good theatre practice.