Medical and surgical care remain a critical feature of disaster preparedness. The evolution of modern warfare introduces elements manifesting as both domestic and foreign terrorism. The fields of disaster and counterterrorism medicine continue to evolve in response to these looming threats. While perhaps not common, education, preparedness, and medical/surgical capabilities are paramount to an effective disaster and counterterrorism medical (and surgical) response. The present study examines the specific role of the surgeon within the scope of disaster and counterterrorism medicine.