Purpose We evaluated the attitudes of female and male surgeons in Hong Kong to work, personal life, and work–life balance, through a questionnaire survey. Methods We sent an online questionnaire survey designed by a female Japanese surgeon to 142 female surgeons practicing in Hong Kong, while its customized version was sent to 953 of their male counterparts. Results “Home life” and “Work” were the first and second priorities for both the women and the men. More of the female surgeons reported that they could not find enough time to participate in community activities ( p  = 0.038) or rest ( p  = 0.024). Both reported moderate satisfaction at work ( p  = 0.114) and in their life outside work ( p  = 0.346), as well as equality at home ( p  = 0.548) and at work ( p  = 0.177). Of the men, 89 % agreed with the necessity for granting paternity leave and reported that they would like to work part-time during the child-rearing years ( p  = 0.013). Conclusions The number of female surgeons involved in key roles is increasing in parallel with the increasing number of female medical students. The introduction of paternity leave for male surgeons is an important concern. The issues of work–life balance may need to be addressed to attract more talent into an important specialty in Hong Kong and this is likely to apply to other parts of Asia as well.