Surgical care has an incontrovertible, crosscutting role in achieving child health. Children develop different surgical diseases compared to adults, present unique anesthetic challenges, and have special perioperative needs. The Optimal Resources for Children’s Surgery document provides a strategy for integrating surgical care for children into National Surgical, Obstetric and Anesthesia Plans. There is an important opportunity to prevent death and reduce disability in children by scaling up surgical care in low- and middle-income countries.