'On the day' cancellations carry significant consequences. This article reviews all cases that were cancelled on the day of surgery within the general surgical directorate of the Royal Hallamshire Hospital, Sheffield from 2005 - 2010. 978 cancellations were made on the day of surgery. Most significant reasons were due to patients' fitness (40%) and lack of theatre time (21%). The conclusion is drawn that 80% of cancellations are avoidable or potentially avoidable, and we suggest implementation of further strategies to reduce cancellations.