Summary: The global burden of musculoskeletal conditions and injuries is large and escalating, especially in developing countries already struggling with the devastation of poverty, HIV, and shortage of healthcare workers. In order to fill the gap in essential musculoskeletal surgical needs in the developing world, there has been a long tradition of surgeons from the developed world reaching out to provide surgical services and equipment. In recent years, growing interest in creating more sustainable approaches for global orthopaedic surgical intervention has prompted some to revisit this traditional model of intervention and to develop new strategies that focus on creating sustainable change. The Institute for Global Orthopaedics and Traumatology (IGOT) at University of California San Francisco and the San Francisco General Hospital has embarked on an innovative and comprehensive academic approach to addressing global orthopaedic needs. The focus of the organization's efforts is targeted on the development of a sustainable model to improve musculoskeletal care in the developing world. Academic partnerships are actively being developed to act as the means to build infrastructure, allowing each country to build its own capacity, to address its own problems, and to answer its own clinical and policy questions. To date, partnerships have been established in Nicaragua, Uganda, and South Africa, working toward mutual beneficial goals. Along the way, efforts are being made to monitor the efficacy of each initiative in order to ascertain whether such efforts truly result in sustainable changes in orthopaedic care. IGOT is headquartered in the Orthopaedic Trauma Institute at San Francisco General Hospital. This institute contains basic science, clinical, and biomechanical research facilities, coupled with fully equipped anatomy laboratories and conference centers. These academic resources facilitate collaboration with a variety of investigators and clinicians to expedite the translation of findings from bench to bedside. IGOT is able to access these resources and to utilize them in collaboration with its overseas partners For the foreseeable future, IGOT will focus on creating site-specific approaches to address the pandemic of injuries in the developing world. It will do this by promoting academic, research, and educational initiatives where overseas partners can be found.