Born at Ealing on 26 July 1854, the fourth and youngest son of William John Little, MD, FRCP, and Eliza, his wife, daughter of Thomas Roff Tamplin, of Lewes, Sussex. Dr Little (1810-1894) his father, early became interested in orthopaedics because he had a shortened tendo Achillis, which was divided by Louis Stromeyer of Hanover, who afterwards became a life-long friend. Dr Little was the first to draw attention to that form of spastic paraplegia afterwards known as "Little's disease". He was the founder of the Royal Orthopaedic Hospital. E M Little was admitted to Westminster School on 26 September 1867, and left as a minor candidate, that is to say as one who had stood unsuccessfully for election into College, in December 1869. He worked for a short time in an insurance office and then in a tea-importer's warehouse. Finding a business training uncongenial, he became a student at St George's Hospital and, whilst he was yet unqualified, served as a dresser in the National Aid Society's ambulance during the Turco-Serbian war of 1876. For his services he received the Takova Gold Cross. After a short period (1882-1886) as dispensary surgeon at the Dreadnought Hospital, he was elected surgical registrar at the National Orthopaedic Hospital where he served as surgeon until 1919, when he resigned and was appointed consulting surgeon. From 1895 until 1934 he was surgeon to the Surgical Aid Society succeeding William Allingham. During the war of 1914-18 he acted as surgeon to Queen Mary's Auxiliary Hospital at Roehampton, where disabled officers and men were fitted with artificial limbs, a post which entailed much remodelling of the stumps before an artificial limb could be worn. In this work Little became facile princeps. He remained with the Ministry of Pensions when the war ended, holding the position of a member of the advisory council more especially in connexion with all questions of the fitting of artificial limbs. The results of his experience were published in 1922 in his work *Artificial limbs and amputation stumps*. As a young man he undertook the duties of junior secretary to the International Medical Congress which met in London in 1881, Sir William MacCormac.and Sir George Makins being his immediate superiors. When the Congress met again in London in 1913 he acted as vice-president of the section of orthopaedics. In the same year, 1913, he became the first president of the British Orthopaedic Association and during 1913-1919 he was president of the subsection of orthopaedic surgery of the Royal Society of Medicine. He did much good work for the *British Medical Journal*, serving as one of Ernest Hart's "young men" and becoming a friend of C Louis Taylor and of Sir Dawson Williams. His last years were employed in writing "The First Hundred Years", which formed the basis of the centenary *History of the British Medical Association*. Joining the Association in 1892 he was vice-president of the section of the diseases of children at the Aberdeen meeting in 1914, vice-president of the section of orthopaedics at the Bath meeting in 1925, and president of the same section at the Nottingham meeting in 1926. He married on 11 January 1890 Mary, only daughter of John Burgess Knight, who survived him with three sons and a daughter. He died on 2 October 1935 at 7 Ashley Gardens, Westminster, SW. Mrs Little died on 28 January 1943, aged 82. Muirhead Little lived to see orthopaedic surgery rise from a small and somewhat neglected branch of medicine to a well recognised position, held in high esteem both socially and professionally. Little himself was in part responsible for the social rise and Robert Jones for the operative. Little was transparently honest and was a cultivated gentleman. When he began his professional life three small hospitals were devoted to orthopaedic surgery, the Royal, the National, and the City. Their funds were low and they were not well conducted. Under pressure from the King's Hospital Fund they were amalgamated in 1905, and the Royal National Orthopaedic Hospital was opened in Great Portland Street in 1909. The staff was carefully selected and the hospital was conducted on modern lines. As an operator Little was slow and painstaking, but lack of early surgical opportunities confined him to the older methods of treatment, and he continued to use splints and tenotomies when his colleagues were employing a more advanced technique. Tall in stature, handsome in face, and quiet in speech, he retained these characteristics to the end of his life. He had an excellent memory and his extensive reading gave him an encyclopaedic knowledge of orthopaedic literature. He had many literary hobbies outside his profession. At the Casual Club, of which he was president in 1901 and in 1929, he proved himself a good debater on a large number of topics unconnected with medicine and introduced without preparation. His character was such that he endeared himself to all with whom he was brought into contact. It was said at his hospital that "house surgeons respected him, nurses obeyed him with alacrity, his colleagues consulted him, and he was adored by his patients for he listened even to the most prolix". Publications: *Medical and surgical aspects of in-knee (Genu valgum)*, by W T Little assisted by E M Little. London, 1882. *Artificial limbs and amputation stumps: a practical handbook*. London, 1922. *History of the British Medical Association 1832-1932*. London 1932. Glisson as an orthopaedic surgeon. *Proc Roy Soc Med* 1925-26, 19, History section, 111-122. A clinical notebook of 1710. *Brit med J* 1928, 2, 1052, describing the MS notebook of Thomas Wallace, containing notes of cases at St Thomas's Hospital in 1710. The MS was presented by Mr W Reeve Wallace to the Royal College of Surgeons Library in 1933. Orthopaedics before Stromeyer. *The Robert Jones Birthday Volume*, Oxford, 1928, pp 1-26.