The selection of an appropriate suture pattern is important to the successful outcome of surgery. The surgeon's aim is to choose a suture pattern that will close the incision and give maximum mechanical support with minimal tissue retraction. Halsted's surgical principles are as applicable during the closure of the incision as they are to its opening. Using the correct suture pattern will help to restore anatomical alignment of tissues, obliterate dead space, minimize tissue trauma and preserve blood supply to the tissues. Perhaps the most vital component of the correct suture pattern is the surgical knot. Tying a secure knot will provide an anchor for the pattern to stay intact and perform its intended purpose. This chapter will review many of the common suture patterns for particular wounds, as well as discussing the importance of knot selection and tying techniques. The following are covered: Classification of patterns; Suture patterns; Rational pattern selection for particular wound closures; and Knot tying. This chapter also includes guides to performing the Two-handed square knot for right-handed surgeons; the One-handed square knot for right-handed surgeons; and the Instrument tie for right-handed surgeons.