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BACKGROUND: rd Operating rooms (ORs) cost constitute a major investment of healthcare resources, approximating 1/3 of the total hospital budget and are among the most important areas of the hospital, contributing to both the workload and the revenue. OR efficiency is dened functionally in terms of underutilized and overutilized hours of ORtime. METHOD: A two p art study containing a prospective analysis time motion study of the operating room (OR) database to retrieve only the cases involving ve major operation theatres followed by a dichotomous open formal questionnaire with yes or no options to take the opinion of the operating room staff i.e., consultants, residents (both surgeons and anesthetists) and nurses RESULTS: Based on the time motion study the delays were mostly identied in T1-Wheel in time, T2- Anesthesia induction T6-cleaning of OR. In part 2 of the study it was evident that 65 % of the staff were of an opinion that OR is currently underutilized, 45% of the staff opined that signicant time is wasted between two surgeries and 75 % opined that they couldn't complete the scheduled list. CONCLUSIONS : Proper scheduling of regular cases and clarity in preparation of OT list, augmenting the man power, establishment good supply chain by providing sub stores in operation operating room, arrangement of sterile supplies and other equipment for the OR adequately by nursing staff could possibly lead in effective utilization of the Operating room time