Abstract: Surgical ligatures are a critical component of any surgical procedure since they are the device that provides immediate post-surgical tissue apposition. There have been several studies to improve the design and use of these wound closure devices for different surgical procedures. Yet, there is no standardized technique or device that can be used for any specific application. Over the last two decades, there has been an increased focus on the innovative surgical sutures known as knotless or barbed sutures, along with studies focusing on their advantages and disadvantages in clinical environments. Barbed sutures were invented to reduce the localized stress on the approximated tissues as well as facilitating the surgical technique and improving the clinical outcome for the patient. This review article discusses how barbed sutures evolved from the first patent published in 1964 and how these barbed sutures influence the surgical outcomes in different procedures ranging from cosmetic surgery to orthopedic surgery performed on both human patients and animals.1. Introduction Wound closure devices are used to ligate the incision during a surgical intervention as well as maintain tissue approximation for the duration of wound healing [1,2]. Wound closure is usually the final stage of surgical intervention, which can be performed in three stages, primary, secondary and tertiary closures, which are influenced by the amount of available surrounding tissue for closure and the type and depth of the wound. Wound closure devices are specifically designed to close a wound by holding the diseased, injured or incised tissue together with the help of one of the following devices: surgical sutures, staples, surgical zippers, clips, adhesive tape or adhesive strips, tissue adhesives or laser bonding. These devices are widely used to close cutaneous or skin wounds [3,4], and are designed and fabricated from various materials depending on the precise anatomical site and the function of the approximated tissues. These devices can either be fabricated from permanent or biodegradable materials depending on the longevity of their active function in vivo [2,5]. Medical surgical sutures are the most common type of ligature that has been used during surgical procedures for wound closure and tissue approximation [6]. Sutures contribute to the largest percentage of devices used for wound closure, yet there is no standardized method for securing them [1]. Sutures have been used for wound closure for thousands of years. They were mentioned in ancient Egyptian hieroglyphics, which date back as far as 3000 BC [7]. For several centuries people used natural plant and animal materials such as hemp, cotton, silk and material removed from animals such as tendons and arteries. More recently, they started using catgut, which is made by cutting fine monofilament threads from the intestines of sheep (ovine), cows (bovine) and pigs (porcine) .