Surgical smoke (SS) is a byproduct of tissue pyrolysis that pollutes the operating room (OR) atmosphere, and its inhalation constitutes an occupational risk for all OR personnel. Research strongly suggests that SS is a chemical, mutagenic, carcinogenic, and biologic hazard. Smoke evacuation devices (SEDs) constitute the most effective means of SS removal, but they are not routinely employed nationwide despite recommendations from professional and government agencies. This quality improvement project's goal was to generate a descriptive analysis regarding the state of SS evacuation and SED use at Oregon Health & Science University South ORs and identify perceived barriers to SED utilization during a recent one-year period beginning November 1, 2019. This analysis relied on Roger's Diffusion of Innovation Theory, the Institute for Healthcare Improvement’s Model for Improvement, surveys, targeted interviews, and OR record review. Based on supply utilization, OHSU surgeons used SEDs in approximately 30.8% of surgical cases, with the primary barriers being surgeon refusal due to inconvenience, device bulkiness, and impaired visualization. Approximately half of the surgeons reported no education regarding SS, and these findings suggest that surgeons may adopt more widespread SED use if education and these perceived barriers are addressed. Most survey participants recognized SS as a health hazard and were concerned about their exposure to SS, and most non-surgeons agreed that SEDs should be incorporated into all SS-generating procedures. Registered nurses and certified surgical technologists were most likely to encourage SED use, whereas only 6% of anesthesia providers chose to do so.