In Australia, the role of the Non- Medical Surgical Assistant (NMSA) lacks recognition and professional regulation. This paper reports the findings of a recent survey of Australian perioperative staff [n=ri6] to determine their knowledge and perceptions of the NMSA role. The survey findings confirm that the role is not well established across the Australian health care system. Of concern is that perioperative staff are required to fill the role of surgical assistant on an impromptu basis. NMSAs with no post-graduate qualifications are perceived by perioperative staff to be less equipped in mentoring, leadership, theatre efficiency, safety and procedural knowledge. There was evidence that some perioperative praxes necessitate the role of the NMSA to avoid practices that compromise patient safety.