To manage the surgical procedure in cases with underlying health problems is usually an important challenging topic in surgery. The underlying infectious status of the patient requiring surgical treatment is a big issue in surgery. At present, tropical arbovirus infection, which is transmitted by arthropod, becomes an important public health problem. The emerging and remerging of many arbovirus infections occur in several countries and this brings a great consideration for medical society. The outbreak of the new emerging Zika virus infection causes the problem worldwide. The new Zika virus infection is not only a simple arbovirus infection that causes dengue like febrile illness but also an infection that can result in serious teratogenic effect. It is no doubt that there is urgent need for finding new means for correspondence to the arbovirus infections. In surgery, the arbovirus is also a big concern. Basically, a patient who needs surgery might have underlying health problem. The arbovirus infection is a possible concurrent health problem in a patient requiring surgical management. In fact, this is not a new topic. For several well-known arbovirus infections, the surgical management in the infected patients is done and approved for safety and effectiveness if it is carefully done. For dengue, a classical well-known arbovirus infection, the hemorrhagic complication is a common problem and the surgical management is sometimes required for management of hemorrhage. In dengue patient who requires surgical management, the great concern is on the low platelet count [1]. Nevertheless, if there is a good preoperative preparation, a good intraoperative monitoring and a good post - operative care, there is usually no surgical complication. This seems that the management of the cases with underlying arbovirus infection is not different from those cases without this underlying problem. For the new emerging Zika virus infection, the big consideration is on the surgeon. There is no problem of thrombocytopenia for Zika virus infected patient. But the still unknown topic is the feasibility of blood borne transmission of the Zika virus. Generally, surgeon has to apply standard universal precautions for any cases [2,3]. For the case of Zika virus infected patient, the additional concern should be on the infectious control. In tropical countries, the transmission of the Zika virus by mosquito is possible and the mosquito also exists in the hospital. Hence, the chance that there will be a local transmission of Zika virus from the patient requiring surgical management to the others, including to the medical personnel, in the hospital is possible. At present, arbovirus infection becomes the important consideration in medicine and surgeon has to update the information regarding the arbovirus infection. During practice, the surgeon need to concern that they might deal with an asymptomatic arbovirus infected cases. The good surgical care accompanied with standard precaution and infection control is usually needed. As a basic rule in surgery, a surgeon should follow that mentioned principles regardless the underlying health problem of the patient. Safety of the patient should come first. In the same time, prevention and protection by the surgeon is similarly necessary.