Increasingly surgical clinical trials research needs to adapt to the changing health environment as we move to personalised health approaches, a greater awareness of the need to inform global health and to address generalisability across cultures and health service structures. This leads to the requirement for international collaboration in clinical trial conduct. International trial conduct is however more complex which can cause significant time delays, hinder efficient delivery and hence delay the potential for patient benefit. This toolkit aims to unlock the potential of international collaboration by guiding the efficient set-up and conduct of international surgical trials to provide efficient, faster delivery of surgical research by UK researchers.