Background: The Royal College of Surgeons in England established guidelines in 2008 to standardize the documentation of surgical procedures. Adesh Medical College and Hospital, in line with these guidelines, employs a uniform operation sheet for all surgical procedures. This clinical audit aimed to retrospectively evaluate the quality of handwritten orthopaedic operative notes to assess compliance with established documentation standards. Objective: To retrospectively audit the hand written orthopaedic operative notes according to established guidelines Methods: A retrospective review of 50 orthopaedic operative notes was conducted. Data from these notes were extracted and analyzed to assess the presence or absence of critical documentation elements, including surgery date and time, surgeon identification, procedure details, operative diagnosis, incision specifics, signature, closure techniques, tourniquet time, postoperative instructions, complications, prosthesis details, and serial numbers. Results: Findings revealed that 75% of the procedures were performed by consultants, with registrars responsible for 85% of operative note documentation. Key elements such as date and time of surgery, surgeon's name, procedure name, and signature were consistently documented in all cases. However, operative diagnosis and postoperative instructions were frequently omitted from their designated sections. Incision details were recorded in 80% of cases, prosthesis details in only 30%, and tourniquet times were absent in all cases. Conclusions: This clinical audit highlights both strengths and areas in need of improvement in orthopaedic operative note documentation. While certain aspects met high standards, there is a clear need for enhanced documentation practices, particularly concerning tourniquet times, prosthesis and incision details, and the consistent placement of operative diagnoses and postoperative instructions.