This review summarizes the current state of knowledge regarding surgical errors, and discusses patient safety in surgical education through use of novel approaches to training and skill maintenance. The types of surgical errors are reviewed, ranging from slips and lapses (which are more common in procedures by experienced surgeons) to knowledge and technical errors. The authors advocate for redesigning surgical education to focus on objective, skill-based measurements, review current methods of evaluating technical skills, and propose increased use of simulation training as a core component of residency training.