For most surgeons and surgical educators, e-learning is relatively new and confusing. This article attempts to explain the key concepts behind e-learning, as well as its benefits and risks. E-learning has become a fixed feature within Higher and Professional Education and has been prioritized by Universities around the world, as well as all six Surgical Royal Colleges. Trainees have grown up with virtual learning environments and expect similar provision for their postgraduate studies, but have a greater need for basic science learning. Dispersal of trainees across duty rotas and geographically makes e-learning more attractive, but preserving peer and trainer communication is as important as content. Recent changes in surgical education and training have also made electronic and distance learning more attractive than previously. Initial work by the Colleges is now being evaluated and important lessons have emerged. The UK Department of Health has made medical e-learning a priority and it is now the largest e-learning provider in Europe. Changes in the World Wide Web, with a shift to more social-networking activity in education and to web-based delivery to small, ubiquitous portable devices will increase opportunities for surgical e-learning.