Psychological safety is a shared belief that team members can voice concerns, ask questions or admit errors without fear of negative repercussions. It is a key determinant of team performance, communication and overall patient safety. Traditional surgical paradigms have been perceived to inadequately prioritise psychological safety, delaying escalation and increasing the risk of errors. As surgical practice evolves, it is imperative methods that cultivate psychological safety within the surgical team are explored, implemented and embedded. A narrative review of literature was undertaken, examining the role of psychological safety in surgical teams, factors influencing its presence and interventions designed to improve it. Psychological safety correlates with improved error reporting, effective team communication and reduced adverse events. Barriers include rigid hierarchies, poor feedback culture, lack of structured debriefing and fear of repercussions. Strategies to improve psychological safety include structured briefings and debriefings, leadership training, explicit encouragement of speaking up during critical tasks and team-based simulation exercises. Implementing these strategies has been associated with considerable improvements in trainee confidence, team collaboration and overall, patient care. Psychological safety is a modifiable factor with significant implications for surgical patient safety and team performance. Promoting a culture where team members feel empowered to speak up should be an explicit goal for surgical units. Surgeons and training programs should prioritise interventions that flatten hierarchical barriers, encourage open communication and integrate psychological safety into routine practice and education. References: 1.Cui CL, Tuttle B, Coleman DM. A narrative review of psychological safety in the surgical learning environment. Semin Vasc Surg. 2025;38(2):176-183. doi:10.1053/j.semvascsurg.2025.04.008