New innovations in Surgery are common, and often touted as being Cost-effective with the recommendation to adopt them into practice. Unfortunately, the term “cost-effectiveCost-effective is, more often than not, misused in the surgical literature. This misuse may have direct consequences if surgeons adopt new techniques or approaches that are not truly cost-effective. In this chapter, readers will be introduced to common terminology used in Economic evaluation. This chapter, explains the four main forms of economic evaluations: Cost Analysis (Cost analysis, Cost-Effectiveness Analysis (Cost-effectiveness analysis, Cost–Utility Analysis (Cost–utility analysis, and Cost–Benefit Cost–benefit analysis. It will also help the reader Appraise and understand an article that purports to be an economic evaluation in surgery. Finally, hopefully, it will stimulate surgeon-investigators to perform Economic evaluation parallel Randomized Controlled Trials (RCTs) that compare a novel Intervention to standard practice.