In September 2015, United Nations member states will adopt a new set of Sustainable Development Goals (SDGs) with a 2030 end date. A landmark report, called Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development makes the case that sustainable development will be hard to achieve unless the international health and development community addresses the enormous global burden of surgical conditions. The report, by The Lancet Commission on Global Surgery, an international group of 25 health experts, shows that surgical conditions impede economic development in low-income and middle-income countries (LMICs), where access to surgical care is poor. Without urgent investment in the scale-up of surgical services, these conditions will be a major barrier to national income growth, economic productivity, and improved human welfare. Surgical scale-up will require mobilization of both domestic and international finance and resources in most LMICs. However the estimated costs are small relative to the economic and welfare returns on investment countries will experience. These findings provide a compelling rationale for national governments in LMICs, as well as donor agencies, to increase both investments in surgical services and in the national health systems required to support their delivery.