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This paper discusses the multiple unique problems encountered in surgical nursing, both pre- and postoperatively, in patients with hematologic malignancies. Medical, psychosocial and unique surgical procedures in this group are reviewed in context of their significance, pathophysiology and active interventive steps necessary. Medical problems include cytopenias, infection, poor wound healing, and malnutrition. Psychosocial problems ranging from economics to fear of dying are discussed in context of an active nursing role. Finally, certain unique surgical procedures, such as staging in lymphomas, are reviewed in terms of necessity, benefits and risks, in order that informed preoperative counseling may be given to patients.