Circumcision is a practice that dates back to the Stone Age, when flint knives were used to perform this delicate task. Since that time, different implements and techniques for their use have been employed. In 1935, an instrument that reduced the incidence of hemorrhage and infection, which continued to complicate circumcisions, was first described in the medical literature of this country; for nearly 60 years, the Gomco clamp has met and exceeded expectations despite the emergence of other clamps and devices. This article addresses refinements that have evolved in the Gomco clamp technique. These refinements combine the highest degree of safety with the least trauma to the newborn. Step-by-step detailing of this surgical skill and implications for practitioners are explored in depth.