Nearly 5 billion of the world’s growing population lacks access to safe, accessible and equitable surgical care. It results in millions of disabilities and death due to common diseases treated surgically. The severe shortage of the surgical workforce, as well as the unequal distribution of providers in urban, compared with rural areas, is a challenge faced by many communities. Global surgery academic partnerships between institutions in high-income countries (HICs) and low-middle income countries have played an essential role in developing surgical workforce capacity. There is also an increased interest from students and trainees in HICs to partake in international training opportunities. However, not all partnerships are equal and sometimes raise critical ethical concerns. Various recommendations have been made to define and create equitable, sustainable and ethical collaborations that focus on the priorities of the low-middle-income country (LMIC) institutions and trainees. In this article, we review some of the academic partnerships that exist and other training models that provide sustainable and accessible education and resources for mutual learning between surgical trainees from both high-income and low-middle income countries. There is an overwhelming need for high-income and low-income institutions to work together to create equitable and ethical partnerships and build a workforce to provide safe and accessible surgery for all.