The first official meeting of the College was in Dunedin on 5 February 1927, when the first Council was declared, and Sir George Syme was confirmed as President. This brief paper discusses why the foundation of the College was not an easy process rather the evolution of a complex series of proposals, and negotiations. A Surgical Association of Melbourne had been formed in 1920 and this consisted primarily of surgeons from the main teaching hospitals. At the Surgical section of the British Medical association in 1920, Louis Barnett proposed a body to raise surgical standards and recognize surgical expertise. A watered-down version of the proposal was eventually accepted but opposition was fierce. Henry Newland famously called the proposal ‘A Dagger in the heart of the BMA’. However, all was not lost, after 1924, dedicated individuals such as Hugh Devine and others worked against the odds to create an Australasian surgical college. Their efforts have allowed us to celebrate our centenary in 2027.