Pathology is a relatively new specialty in the history of medicine and borrows much from the clinical and basic sciences. The clinicopathologic correlation began with deceased (autopsy) and was later extended to the living (surgical pathology). Although the roots of surgical pathology began during the first half of the 19th century, this distinctive specialty evolved through many subsequent technical and scientific discoveries. This historical review will trace the advances in microscopy, histochemistry, and surgery in the later half of the 19th century and early 20th century that led to the development of modern surgical pathology.