After the establishment of the hospital to fulfill the objectives of IOM, this hospital has become popular among not only the Nepalese but Foreigners as well for its cleanliness, service oriented and state of art facilities, and of course, expert doctors. Although it is good news, the rapidly increasing demands for services at TUTH have made space both in-patient and out-patient inadequate for patient care and for effective teaching/ learning activities. Moreover, TUTH cannot effectively discharge its function of teaching and providing quality services if it is loaded with large number of patients with minor aliments nor requiring the attention of highly trained university faculty. Patients having to wait for months for any operative procedure is an established fact in all the surgical departments. Thus, to move forward, we have chalked out our vision and future mission. Any suggestion on this topic is welcome and we will look into it with serious consideration.