The term “Orthopaedics” was derived from the book Orthopédie on childhood deformity correction by Nicolas Andry in 1741. The frontispiece of the book, “Tree of Andry” has become a common logo of orthopaedic associations worldwide. Historically, western Orthopaedic and Trauma care can arbitrarily be divided into Greek and Roman period, renaissance period (14th to 17th century) and modern period. Hippocrates, the father of medicine, is credited for several techniques in orthopaedic and trauma and a lot of work was done during the renaissance period on fracture management including amputation. Hugh Owen Thomas, son of a bonesetter, who published many incredible works is considered as the father of modern orthopaedics in the UK. The use of Thomas traction splint during the First World War dramatically reduced the incidence of death due to femoral fractures and eventually, after the World War II, Orthopaedics and Trauma surgery became one of the major disciplines in medical fraternity. In the 19th century, Japanese orthopaedic surgeons developed surgical techniques in cervical spine, arthroscopy and use of tissue culture. Whereas in China, western orthopaedics was first introduced in the early twentieth century and since then, Chinese scholars have been contributing significantly to the field. In Indian subcontinent, practice of Vedic medicine was started by Dhanvantary. Production of the medical treatises (Charaka-samhita and Sushruta-samhita) were produced by Charaka, a physician, and Sushruta, a surgeon during 800 bce to about 1000 ce, is said to be the golden era of medicine. History of modern medicine is relatively new in Nepal. Orthopaedic and traumatic conditions were treated by traditional bonesetters, general physicians and general surgeons in the past. Orthopaedic services started in Nepal in the nineteen seventies by very few trained orthopaedic surgeons. It quickly expanded every year thereafter with increase in number of trained orthopaedicians. Initiation of post graduate Orthopaedic and Trauma Surgery training by Institute of Medicine, Tribhuvan University in 1997 was another important milestone in Orthopaedic service in the country. Currently, each year about fifty Orthopaedic surgeons are being trained under Universities (TU and KU) and Academies (BPKIHS, NAMS and PAHS), and some of the graduates are from abroad. There are about five hundred orthopaedic surgeons in Nepal currently, working in different corners of the country and with time, orthopedics has evolved into many subspecialties in the country. With about a half century experience of service, more than two decades of orthopaedic training and existing subspecialty societies, we are now in a strong position to train our people in specific field within the country. It is now a high time to start fellowship programs in different sub-specialty areas of orthopaedic and trauma surgery. A fellowship-trained orthopedic surgeon who has completed an additional period of specialty training in a specific field of orthopedic surgery in an accredited fellowship program can provide better care of patients. It is a matter of pride that some of the academic institutions and hospitals in Nepal have already started fellowship programs and some are in the process of starting it in near the future. Selection of the candidates, proper clinical exposure, evaluation process and audit of national need are some of the matters to be addressed. Nepal Orthopaedic Association being a professional mother organization has to play a pivotal role to facilitate and co-ordinate the fellowship programs so that our members can work as a subspecialist fellow in different corners of the country and provide more enhanced care to the patients.