Surgical care is often delivered in time-pressured environments where efficiency, technical precision and task-oriented workflow is prioritised. These contraints can often unintentionally limit opportunities for meaningful communication and culturally safe care for Indigenous patients. However, surgical experiences are shaped by more than clinical outcomes alone and must incorporate trust, communication and inclusive care across the peri-operative continuum. This presentation explores how the entire pathway can either strengthen or undermine trust in surgical care, from pre-operative discussions, intra-operative dynamics and post-operative recovery. Key themes include understanding consent as an ongoing relational process rather than a single signed document, recognising communication barriers and implicit assumptions, as well as considering the role of family members, Elders and cultural practices in surgical decision-making. By examining common points of misalignment between surgical systems and the needs of individual Indigenous patients, this presentation aims to highlight practical reflections focused on improving operative experiences. Overall, it delineates that cultural safety should be presented, not as an added task, but as an integral component of high-quality surgical care.