Background The Emergency Hospital in Battambang, Cambodia, is essentially a surgical center for victims of injuries. Methods Using methods previously described, operating costs were calculated, and effectiveness of treatment was estimated for 957 patients undergoing 895 surgical procedures over a 3 month period (October-December 2006). Results Results of the cost-effectiveness analysis are compared to the few existing ones in the literature. Conclusion At $77.4 per DALY averted, surgery for trauma in such a context is deemed very cost-effective and compares favorably to other non-surgical public health interventions.