Liberia has an extreme health workforce shortage, particularly with respect to surgery. JJ Dossen Memorial (JJD) is a public referral hospital supported by Partners in Health. We designed and implemented a comprehensive surgical program at JJD. Using case logs, clinic records, and transfer data between December 2016 and April 2018, we evaluated the impact of this program on the surgical cohort and examined temporal trends in patient origin using GIS. The mean number of cases per day increased from 1.7 ± 1.0 to 2.4 ± 1.3 (p