This book  is aimed at providing clarity to the surgical residents and students on the tissue approximation and knotting, an integral part of surgery, a science and art involving application of appropriate knowledge and skill to achieve healing of the wounds. The book has seven chapters, divided into different levels and aspects of tissue approximation, starting from the historic evolution of the scientific art, knowledge-based conceptualization leading to the actual performance of the art in its various forms, conventional and modern, apt to the contemporary practice of surgery, including the suturing and knotting techniques in minimally invasive surgery. The chapters are rich with illustrations, diagrams and photographs to enrich one’s experience of “virtually being there”