The objective of the Texas Surgical society is "the stimulation and improvement of the art and science of surgery, and the elevation of the standards of the practice of medicine." (from Article II of the Constitution and By-Laws).

The Texas Surgical Society was officially founded on March 6, 1915 in Houston, Texas. The leader of the founding movement was Dr. James E. Thompson of Galveston.

There were twenty one charter members who signed the same Fellowship Pledge still in use today. There were four qualifications for membership:
High moral standing in the community.
High ethical standing in the community.
No participation in fee splitting for referrals.
Practice limited to surgery.

The first scientific session was held in San Antonio on October 18-19, 1915. Dr. Thompson delivered the presidential address to fifteen members. The Scientific Session has been held at least yearly since then and semi-annually since 1943. At the meetings, scientific papers are delivered by the members and an outside Honor Guest Speaker is featured. Attending the meetings are Active Fellows, Senior Fellows, Honary Fellows and invited guests. Discussion is invited and encouraged by all members and invited guests.

The president of the Texas Surgical Society delivers his yearly address at the Presidential Banquet during the Fall meeting. The Texas Surgical Society is currently limited to 300 Active Fellows.

The continuation of Texas surgical history has always been an important tradition in the Texas Surgical Society. Cabeza de Vaca performed the first surgical procedure in the New World in Texas in 1535. He excised an arrowhead from the chest of an Indian and sutured the wound closed. The patient survived and also, therefore, so did Cabeza de Vaca. The importance of this to the Society is exemplified in the inclusion of Cabeza de Vaca in the Texas Surgical Society logo.