Surgical smoke (SS) is generated by various instruments used for surgical procedures and poses many occupational hazards to operating room (OR) personnel. Adverse health consequences result from mutagenic, chemical, and carcinogenic effects of SS, and SS transmits pathogenic biological agents. For this reason, numerous professional and governmental organizations recommend the routine use of surgical smoke evacuation devices (SEDs). The Veteran Administration Portland Health Care System (VA) has 10 ORs and 4 minor procedure rooms that generate a significant amount of SS daily. This quality improvement initiative defined the current state of SS evacuation at the VA and identified perceived barriers to SED use at that institution for the 6-month period from June 1, 2020 through December 31, 2020.