We compare strategies to manage surgical waiting times in Australia, Canada, England, New Zealand, and Wales to give policy insights into those that are most effective. Most of these countries have allocated dedicated funding and set explicit waiting time targets. Of the five countries, England has achieved the most sustained improvement, linked to major funding boosts, ambitious waiting-time targets, and a rigorous performance management system. While supply-side strategies are used in all five countries, New Zealand and parts of Canada have also invested in demand-side strategies through the use of clinical criteria to prioritize access to surgery.