Review of malpractice litigation is a longstanding method for identifying patient safety vulnerabilities. Investigators reviewed a legal database for malpractice cases involving surgical trainees between 2005 and 2015. During the 10-year period, 87 cases were identified. Most cases involved perioperative management for elective surgery, and more than half of cases implicated inadequate supervision as a contributing cause. As with previous research on closed malpractice claims, a majority of these cases had an outcome of permanent disability or death. The authors recommend increased attending supervision during the perioperative period in order to prevent risk for litigation. A past PSNet perspective recommended continued appropriate supervision for optimal patient safety.