How to Tie a Surgeon’s Knot (Step-By-Step With Video)

The Surgeon's Knot is one of the most important fly fishing knots there is. Learn how to tie a Surgeon's Knot with this easy to follow video.

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In this article, we’ll have a look at how to tie the Surgeon’s Knot. It’s an important knot to have in your arsenal and one you’ll need more often than you know.

Many freshwater applications call for the use of two, or more, flies. One method to set up such a rig is to attach the flies in a truck and trailer configuration. This means that there’s a piece of tippet connected to each fly’s hook bend. I still use this method when I need to make a quick plan, but it’s not ideal.

The best way to set up your multi-fly rig is by using a Surgeon’s Knot.

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In fly fishing, the two main applications for the Surgeon’s Knot is to join two similar diameter leaders or tippets together and to create a dropper rig.

Joining Two Lines

The Surgeon’s Knot can be used to join two lines of similar diameter to each other. This can be useful the extend tippets or add a highly visible piece of line to the leader.

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Dropper Rig

The Surgeon’s Knot can be used to create a dropper rig, which allows the angler to fish two flies simultaneously. This is my favorite knot to set up these rigs as it’s very fast to tie and more than strong enough for most freshwater applications.


Although the Surgeon’s Knot may be used to join two lines together, there are better knots for this application if you’re not setting up a dropper rig. The Uni-Knot and Blood Knot offer superior strength and can be used to join different diameter tippets as well.

Having said that, when you’re in a pickle and need to join two lines very fast, the Surgeon’s Knot will do the trick.

Watch The Video

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Let’s Get Started!

How To Tie a Surgeon’s Knot

Below, I go through the step-by-step procedure to teach you how to tie a Surgeon’s Knot. Be sure to follow along with the video above while you’re tying your own line so that you can master this useful knot.

Step 1: Lay The Two Lines Against Each Other

Lay the standing line (going to the reel) and the section of the tippet you’re adding against each other.

Allow them to overlap more than 3 inches as this will give you enough free line to work with.

surgeon's knot_step1

Step 2: Form a Loop

Form a loop with both lines as if you’re going to tie a double overhand knot. A good piece of advice is to form the loop as far up the running line as possible, especially when you’re going to use the knot for a dropper rig.

In this way, you’ll have a long enough tag end for the dropper.

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Step 3: Pass Both Lines Through The Loop

Pass both lines simultaneously though the loop twice (for the Double Surgeon’s Knot) or three times (for the Triple Surgeon’s Knot).

I recommend the Double Surgeon’s Knot for tippets ranging from 1X to 4X. Anything smaller than that, make one more wrap for the Triple Surgeon’s Knot.

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Step 4: Tighten The Knot Part Way

Now, pull on all four lines at once to bring the knot together.

Ensure that all the loops are the same size which will mean that they will be seated at the same time.

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Step 5: Wet The Knot

This is an important step to help seat the knot properly and ensure it stays tightly held together.

You can use water if you’d like for this, but most fly fishermen and women will just place the partially tightened knot in their mouths to give it a generous helping of saliva.

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Step 6: Pull The Knot Tight

Pull all four lines again until the knot has come together completely. You can get the knot pretty tight by pulling these four lines, but at this stage, the knot is not yet fully seated.

In the next step, we finalize the knot and ensure that it’s fully seated and in place.

surgeon's knot_step6

Step 7: Seat The Knot

Let go of the two short tag ends and pull on the attached tippet and standing line. This will seat the knot into its final position.

You’ll know that the knot is fully seated and that you’ve done it correctly if is looks like the photo to the right.

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Step 8: Trim The Tag Ends

Trim both tag ends leaving a very short piece protruding from the knot.

Be careful when removing the tag ends not to accidentally clip knot or tippet material.

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Step 9: Test The Knot

Test the knot to make sure that it can handle the required load as per the tippet strength.

You should be able to pull very tight on a well-tied Surgeon’s Knot and it should not come loose or slide out of place.

surgeon's knot_step9

Surgeon’s Knot For A Double Dropper Rig

The Surgeon’s Knot can be used to set up a dropper rig. We make use of the exact same knot, but finish it in a different way.

Step 1: Tie The Surgeon’s Knot As Described Above

Use the same procedure as set out in the previous section. Use a Double Surgeon’s Knot for 1X to 4X and a Triple Surgeon’s for 5X and smaller. We jump in after you’ve seated the knot, right before you trim the tag ends.

surgeon's knot_step4

Step 2: Which Tag End is Which?

After tying the knot, there are two tag ends and two standing lines. The one standing line comes from the rod’s tip and the other is the piece of tippet you’ve attached.

The top tag end in the knot is from the newly attached tippet and the bottom tag end is from the original standing line.

surgeon's knot second part_step4

Step 3: Form An Overhand Knot In The Bottom Tag End

The bottom tag end (which is the tip of the original standing line) will form the dropper. However, at this stage, the angle between the new tippet and this tag end is so small that a fly will continue to fowl around it.

Take the bottom tag end and form an overhand knot around the new tippet.

surgeon's knot second part_step3

Step 4: Pull The Overhand Knot Tight

Pull the overhand knot tight ensuring that it seats up against the bottom of the Surgeon’s Knot. You will clearly see that this creates a 90-degree angle for the dropper.

surgeon's knot second part_step4

Step 5: Trim The Tag End

Trim the top tag end leaving a very short section protruding from the knot.

With Surgeon’s Knots, whether you’re making a double dropper or attaching two types of line together, you can cut the tag ends quite close.

surgeon's knot second part_step5

Step 6: Test The Knot

Test the knot by holding onto the top standing line and pulling the newly attached bottom tippet.

Also, test the dropper to ensure it can handle the required force.

surgeon's knot second part_step6

Step 7: Attach The Flies

Once you’re happy with the knot strength you can attach a top and bottom fly.

This double rig is popular with Euro Nymphing and can be one of the most effective ways to catch finicky fish.

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The Finished Surgeon’s Knot

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Now You Know

How To Tie a Surgeon’s Knot

As you can see from the steps above, the Surgeon’s Knot is very simple to tie. Once you get the hang of it, you’ll be able to join two lines or set up a dropper rig in less than 30 seconds. As always, practice the knots as much as possible. Before you know it, your fingers will tie the knot without you even having to look.

Please leave any comments or questions at the bottom of the page. Let us know what knots you prefer and your experiences with the Surgeon’s Knot.

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Learn How to Tie a Surgeon’s Knot: A Step-By-Step GuideHow to Tie a Surgeon’s Knot

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Pierre is a fly fishing guide and professional photographer who has guided and hosted trips for top fly fishing outfitters. Since being introduced to fly fishing over 21 years ago, he has travelled, fished and guided across the globe. He has extensive knowledge on specific gear and tackle selection for various salt- and freshwater species. Some of his writing work includes blogposts for Alphonse Fishing Company and African Waters.

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