The original publishing contract for the British Journal of Surgery was signed in 1913 by celebrated surgeon, Berkeley Moynihan, who chaired the Editorial Board for 24 years.

The first Editor was Ernest Hey Groves, who continued his role for a mere 27 years. The journal might have foundered with the outbreak of the First World War, but Hey Groves persuaded the Editorial Board to continue with an emphasis on military trauma. A focus on relevant and emerging topics in surgery has been the hallmark of the journal ever since.

Over the next 50 years, the journal published scientific articles and case reports related to all branches of surgery. However, the emergence of surgical specialties with their professional societies led to the journal predominantly covering general surgery. Developments in surgical science and a greater emphasis on research saw the journal move away from its traditional British base towards a global readership. By the end of the 20th century, it was recognised as the leading general surgical publication in Europe. In 2002, the journal incorporated the European Journal of Surgery, followed by Swiss Surgery and became the official journal for a number of surgical associations across Europe. The Editorial team responsible for the peer review process and selection of journal content reflected these changes. With the appointment of Editors from outside the British Isles and, while still indexed as Br J Surg, the front cover and journal title became BJS.

As a peer-reviewed surgical journal, BJS has continuously sought to attract and publish the highest quality material. However, as surgical science and its dissemination evolved, it became clear that an alternative to the traditional subscription journal was needed. As the reputation and impact factor of BJS grew, the number of manuscripts received doubled over 10 years, reaching almost 2000 submissions annually. As a result, many articles suitable for publication on scientific grounds could not be accommodated.

The emergence of the open access publication meant that authors, research funders and academic institutions could pay for publication, allowing articles to be read online for free. This led to the launch of the BJS Open journal in 2017.