National Confidential Enquiry into Patient Outcome and Death (NCEPOD) states that emergency patients must have prompt access to theatres, critical care facilities and appropriately-trained staff at all times. Due to the increased number of trauma cases treated by our orthopaedic teams a dedicated Day Surgery Trauma List (DSTL) was introduced. This article is a retrospective study of operations, cost implications and patient satisfaction of this list. We reviewed 49 patients operated on by the first author in six months from October 2008 to March 2009. The type of operation, place of operative decision and the time taken from the decision to actual operation was recorded. The cost was analysed with the help of the finance department. Patient satisfaction was calculated from a questionnaire. Decision to operate was taken in accident and emergency in 60% cases and 40% in fracture clinic. The average time from the decision to operation was two days. Cost-benefit to the NHS was £300 per case. 28 patients answered the questionnaire with overall patient satisfaction of 8.57 out of 10. The day surgery trauma list may be used to perform various orthopaedic trauma procedures with significant cost containment (£14 400 in six months). Benefits to patients were specified operative time, reduced waiting times and good clinical care.