This was my second visit to the Tupua Tamasese Meaole Hospital in Apia, Samoa. The aim of the visit was to teach, supervise, mentor and assist the two orthopaedic registrars with the provision of acute and elective services for a two week period. During the visit the Pacific Island Surgeons Association held it's biennial meeting in Apia and so I was able to attend some of the meeting as well. Todd Clevenger was an Orthopaedic Fellow at Tauranga Hospital in 2011 and now practices orthopaedic surgery in Medford, Oregon. He joined me in Samoa for the two weeks for his first experience of Pacific orthopaedics. My senior registrar Dr Charlotte Allen also joined the team for the second week to help cover the orthopaedic service during the week of the PISA meeting to allow the local surgeons to attend as much of the meeting as possible. We were well looked after by our Samoan hosts and made to feel an integral part of the team. We assisted with 21 surgeries during the fortnight, tackling a wide range of orthopaedic problems. Our thanks to Drs Ponifasio, Fuimaono, Taavao, Mauiliu & Samuelu for their hospitality. VP