Five billion people, more than half of humanity, lack access to safe, affordable surgical care. While conventional surgical infrastructure requires decades and trillions of dollars to replicate in low-resource settings, emerging non-incisional technologies offer an alternative paradigm. Histotripsy is a focused ultrasound modality that mechanically destroys tissue without incisions, anesthesia, or prolonged hospitalization. It represents a potential leapfrog technology for addressing the global surgical divide. This editorial examines the technical, economic, and implementation considerations that position histotripsy as a transformative intervention for global surgical equity. We propose a framework for accelerated deployment and outline the policy, research, and financing mechanisms required to realize this potential within a generation.
