The authors present a technique using electrocautery diathermy to make surgical tattoos. This method has been used in over 300 patients who underwent head and neck surgery at Aberdeen Royal Infirmary and Albany Medical College, New York, over a period of five years. A wide variety of operative procedures such as total laryngectomies and neck dissections were performed. The electrocautery surgical tattoos have a major advantage of persisting until the end of the operative procedure by which time other types of tattoos have faded. The technique is widely available, inexpensive, and has to date been complication free.