The British Orthopaedic Association have recommended that all hospitals should have daily, consultant-led, trauma lists. We have prospectively examined the introduction of a daily trauma list on the out-of-hours operating and the management of trauma in one district hospital. The data collected were compared with a corresponding 6-month period in 1996. It was found that the mean usage of the list was 2 h 38 min; 10% of lists were not used. There has been a significant reduction in the number of operations performed out-of-hours, and also a significant reduction in the amount of out-of-hours operating after midnight. More complex cases have also been operated on in normal working hours. The initial introduction of a daily trauma list has had a significant impact on the total amount of out-of-hours operating and has increased consultant supervision of the management of trauma, thereby increasing the quality of care for these patients.