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During the Byzantine period the most prominent medical personalities were Oribasius, Aetius of Amida, Alexander of Tralles, and Paul of Aegina (Paulus Aegineta). The last of the eclectic Greek compilers, Paul of Aegina (625-690 AD) was born on the island of Aegina and practiced medicine in Alexandria. He was the author of the Epitome of Medicine (seven books), which was first printed in Greek by the Aldine Press in Venice in 1528. The Syndenham Society of London published an English translation by Francis Adams of Banchory between 1844 and 1847. The most noteworthy of his Epitome is the sixth book on surgery. Paul was not only a scribe but also a highly capable surgeon. He was the quintessential student of the best medical authorities: Hippocrates and Galen in Greek and Roman medicine, respectively. He also displayed a peculiar genius in the field of surgery. He gave us novel descriptions of tracheotomy, tonsillectomy, catheterization of the bladder, lithotomy, inguinal hernia repair, abdominal paracentesis for ascites, and many other surgical procedures including reduction of breast size. He not only influenced those in his own era but had great influence on physicians such as Rhazes, Haly Abbas, Albucasis, Avicenna, and Fabricius ab Aquapendente, who lived in subsequent eras. This historical article emphasizes the role of Paul of Aegina in the history of surgery and provides a comprehensive review of his surgical treatise with original case examples that represent his contributions to surgical progress.