Background: This study was designed to determine whether there is in fact a European model of acute care surgery and to describe the different care systems in the individual European countries., Methods: Questionnaires were sent to experts on emergency surgery in 27 European countries. The assessment of attitudes toward the emerging discipline of acute care surgery was the main outcome measure., Results: Replies were received from at least one respondent from each of 18 countries. They indicated a high awareness of the new field of acute care surgery, although this has not yet become a recognized (sub-)specialty in any of the countries polled. In addition, several interesting new trends were identified: for example, different approaches depending on individual political influences., Conclusions: There is no European consensus on acute care surgery. In some central European countries, specialists qualify in general and orthopedic trauma surgery; these all rounders also perform life-saving thoracic and neurosurgical procedures, such as emergency thoracotomies and craniotomies. The European model is not a uniform system for acute surgical care.