There is widespread literature on burnout within healthcare and especially surgery. However, what may be more insidious and difficult to recognise, are the contributors to moral injury. Moral injury refers to the psychological, emotional, and ethical distress experienced by healthcare professionals when they are involved in situations that conflict with their moral or ethical beliefs. Unlike traditional burnout or post-traumatic stress, moral injury arises from the perception of having violated one’s own sense of duty or values, often due to external constraints, such as limited resources (time, equipment, multidisciplinary teams), systemic inefficiencies, or difficult decisions about patient care. This is experienced at all levels of care when the practitioner feels unable to provide optimal treatment due to institutional limitations. Recognising moral injury involves identifying signs such as emotional exhaustion, guilt, shame, disillusionment with the healthcare system, and a reduced sense of empathy which may be precipitated by feelings of increased cynicism, depression, or withdrawal from the team or role. Preventing moral injury requires addressing systemic challenges, such as improving staffing levels, providing adequate resources, and fostering a culture of ethical support. Organisational changes, such as ethical training, regular debriefing, peer support networks, and access to mental health care, can help mitigate the impact of moral injury. By fostering an environment that supports ethical reflection and compassion, healthcare systems can protect the well-being of providers and enhance patient care outcomes.