William Rutherford was one of the pioneers of accident and emergency medicine as a specialty in the UK. The son of a Presbyterian minister, he was born on 15 July 1921 at Warrenpoint, County Down. His family moved to Dun Laoghaire near Dublin, but he went to boarding school in Belfast. He rejected Greek to study physics and chemistry instead. In 1939, he entered Trinity College, Dublin, graduating in 1944. He had had qualms about being exempt from service during the Second World War, but was persuaded to continue as a medical student. His father died whilst he was still a student, but a family friend helped financially so William and his sister could finish their medical studies and qualify. After house appointments in Belfast, he felt the call to become a missionary doctor. He accepted an appointment at Anand in Gujarat, India, in 1947, months before independence. He saw the chaos and slaughter as Hindus and Muslims fled to India and Pakistan. As all old fashioned general surgeons, he did orthopaedics and obstetrics and was also responsible for administration, and his standards were high. The hospital closed in 1966 and he returned to Belfast. There he was appointed as a medical assistant in the casualty department of the Royal Victoria Hospital. At this time there was extreme pressure for the specialty of casualty surgeons to be recognised. William was one of the founder members of the Casualty Surgeons’ Association and became president in 1981. The specialty was eventually accepted and in 1972 30 consultants were appointed, of whom he was one. This was at the time when Belfast was the centre of the troubles with the IRA. The Royal Victoria Hospital was in the middle: there were regular mass casualty situations that he and his staff had to deal with. As an experienced surgeon, he was able to train his team and control one of the most efficient departments in the UK. For his inspired work he was appointed OBE in 1971, but he always insisted that this decoration was earned by his department. He wrote and published regularly about his experiences in India and Belfast. He wrote about bomb blasts, gunshot injuries, the damage caused by rubber bullets, cardiac contusion, and injuries treated in his department. Mass casualty situations were discussed and he wrote on the essential requirements for the organisation of a department receiving them. His plan for the Royal Victoria Hospital served as a template for many hospitals. He wrote about scoring the severity of injuries and the social factors, such as unemployment, which affected patterns of injury. The use of seatbelts was a subject that he studied and tried to get enforced. He knew what excellent results there were in Australia. The Government in the UK was dithering, so he carried out and published an excellent report. Figures taken before and after the Act to enforce seat belt wearing showed a significant decline in both deaths and serious injuries. The Act is now accepted by all, thanks to his outstanding work. The development of the specialty of accident and emergency medicine was a serious contribution to medicine in the UK. Similar efforts were being carried out in Australia, Canada and the United States. The International Federation for Emergency Medicine (IFEM) was created and he became a founder member. There are now 21 member countries. William was an active walker and, after retiring in 1985, he walked, in stages, the Ulster Way. He found it gave him space and time to think. William looked after his wife, Ethne, at home until her death from Alzheimer’s disease. Sadly, he was to die of the same disease on 22 December 2007. He was survived by his daughter, a nurse, and two sons, both doctors.