t is widely accepted that inhalation of smoke, specifically, the particulate matter (PM) found within smoke, can cause adverse effects on health. When diathermy devices, such as electrocauterization instruments, lasers, and ultrasonic scalpels, are used during surgery, surgical smoke, also called cautery smoke, surgical plume, laser plume, and diathermy plume, is released into the ambient environment. This process occurs in open surgery as well as laparoscopic surgery, as ports are often vented into the atmosphere. There is a lack of studies regarding the long-term effects of surgical smoke; findings from such studies may inform methods to prevent adverse outcomes on the health of operating room personnel. There are several other forms of smoke that the general population encounters, including secondhand smoke, cooking smoke, and environmental pollution. There have been more in-depth studies on these forms of smoke than of surgical smoke, and they can help bolster the present knowledge of the danger of surgical smoke.Although smoke evacuation devices exist, they are not often used in practice owing to inconvenience and lack of awareness. A study done in 2016 reported that 14% of operating room personnel always used local exhaust ventilation during electrosurgery. 1 These respon-dents were also more likely to report training and employer standard procedures regarding the hazards of surgical smoke. The largest difference in consistent use of local exhaust ventilation was attributed to knowledge and training on the hazards of surgical smoke. 1 Most operating room staff acknowledge adverse symptoms (eg, coughing, headache) from surgical smoke, yet few wear effective personal protection. 2 Although multiple health organizations, such as the Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health, have created guidelines regarding exposure to surgical smoke, no laws mandate that protective measures be taken. 3,4 However, there has been increasing research and awareness of the harmful effects of surgical smoke on operating room personnel, leading to a push to increase regulation of surgical smoke exposure, for example, in the California legislature. 5 Signs regarding the dangers of surgical smoke can be found outside the operating room. 6 The medical community is becoming more sensitive to the possible hazards of surgical smoke exposure. 7 While emphasizing the importance of using current evacuation techniques is important, there are new modalities that could improve smoke evacuation beyond the simple vacuum and filter system. IMPORTANCE Smoke generated during surgical procedures has long been thought to be hazardous to hospital personnel; however, the degree of danger has yet to be determined.OBSERVATIONS The dangers of surgical smoke are associated with the composition of the plume. Small-particulate matter is found in the smoke that is easily inhaled. Particulates deposit in the lungs, circulatory system, and other organs, which may cause numerous health problems....