Optimal shift length for acute care surgery remains an ongoing debate that takes into consideration the impact of fatigue on performance, patient outcomes, and provider well-being. The data is conflicting on whether 12- or 24-hour calls are best. Proponents for the 24-hour shift model cite that it fosters superior continuity of care with fewer handoffs, enhances surgical training and does not negatively impact patient outcomes. Supporters of the 12-hour shift model cite enhanced focus, reduced errors, and promotion of patient safety without compromising training requirements or skill acquisition. A thorough look at the practice environment, frequency of calls, and handoff processes are needed to decide on whether a 12- or 24-hour call schedule will be utilized for trainees and attendings.