How to Tie a Surgeon's Knot

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Project Overview
  • Skill Level: Beginner

In medicine, a surgeon's knot is used to secure suture threads during surgical procedures. However, it's also one of several types of knots useful for making jewelry and working with beads. It's similar to a square knot, but it has an extra pass-through on the first half of the knot. This makes the cords less likely to slip, both while you are tying the knot and once the knot is complete.

Surgeon's knots are a good knot to use with elastic cord. The extra pass-through at the base will help to keep the knot in place while you are tying the second half of the knot. It also makes the knot less likely to untie. Depending on the beadwork stitch being used, a surgeon's knot may be used to join two ends of the beading thread together, such as when tying off the threads or adding a new thread. Using it in this way would depend on having enough room between the beads to add the knot.

Surgeon's knots work well with beading thread such as Nymo or FireLine. They can be used to add a thread to a component, as in brick-stitched bead-wheel earrings. A surgeon's knot can also be used on the thread end to make a bulkier knot that resists slipping through the beading foundation when doing bead embroidery.


Surgeon's knots are not decorative. It is best to use them when you can hide the knot inside of the beadwork or inside of a bead. The surgeon's knot is slightly larger than other knots used in beadwork, so be sure you can pull it inside the hole of the beads you are working with.

What You'll Need


  • Elastic cord
  • GS-Hypo cement or clear nail polish


  1. Start the Knot

    Cross the cord on the left over the cord on the right. Wrap the cord on the right side over the cord in your left hand and bring it back up through the middle.

    Starting a surgeon's knot
    The Spruce / Lisa Yang
  2. Make the Second Loop

    The surgeon's knot has one additional pass-through on the first half of the knot. While still holding the cord from the last step, pass it over and around the other cord one more time. With this, you have made a total of two wraps around the cord.

    Cord wrapped twice to start a surgeon's knot
    The Spruce / Lisa Yang
  3. Finish the Surgeon's Knot

    Bring the right side of the cord over the top of the left and then wrap it around and through the middle of the knot. Pull on each side of the cord to secure the base of the knot. For a little extra security, apply a bit of GS-Hypo Cement or clear nail polish to the top. 

    Put your new knowledge to work. Now that you know how to make a surgeon's knot, learn how to make better elastic-bead bracelets.

    Square knot with an extra loop on the first pass through
    The Spruce / Lisa Yang