Born in London in 1896 the son of Raphael Roche and Grace Simon he was educated at St Paul's School, Magdalene College, Cambridge, where he obtained a classical scholarship, and St Bartholomew's Hospital. After qualifying he held a series of house appointments at St Bartholomew's, culminating in that of chief assistant to the Surgical Unit which he held for five years, after which he became resident surgical officer at St Peter's Hospital for Stone. When proceeding to the degree of MD in 1927 he was *proxime accessit* for the Raymond Horton Smith prize. With this very wide training behind him, he decided to specialise in urology and in 1931 he was appointed to the staff of the West London Hospital as assistant surgeon to Sidney MacDonald, whom in due course he succeeded. He was, in addition, in charge of the Genito-urinary Department at the Royal Northern Hospital and visiting urologist to Hounslow Hospital and to the Teddington, Hampton Wick and District Memorial Hospital and consulting surgeon to LCC Hospitals. He was President of the Section of Urology of the Royal Society of Medicine in 1951, giving an address on "Reflections on Nephrectomy", President of the Hunterian Society, giving the Hunterian Oration in 1963, and President of the West London Medico-Chirurgical Society. An original member of the Urological Club, an exclusive body limited to fifteen members drawn from throughout the British Isles, he was also an original member of the British Association of Urological Surgeons, and much in evidence at their annual meetings. A gifted and fluent writer, he contributed many papers and works on his special subject notably *Pyelography, its History, Technique, Uses and Dangers* 1927, *Urology in General Practice* 1935, and *Practical Urology* 1956. Alex Roche was a remarkable personality, as surgeons who had the privilege of his friendship can testify. Of wide culture and education, a writer of essays and poetry, a fluent French scholar, he was above all else a man of outstanding wit, usually subtle and sometimes above the heads of those at whom it was directed. No slave to convention, his style of dress was highly individual. In the winter he wore under his short black coat and waistcoat a grey wool pullover the sleeves of which protruded round his wrists. Possessor of a prodigious memory for facts and faces, he showed in his lay writings, such as *An Anthology of Wit* 1935, a style reminiscent of Laurence Sterne. A brilliant raconteur he was in great demand as an after dinner speaker. A charming, delightful, conscientious and highly competent surgeon he was without an enemy and, in spite of indifferent health, always radiated good humour. As might be expected a member of the Savage Club, he listed his pastimes as literature, music and walking. He married in 1932 Cicely Mary only daughter of F W Briggs and they had three sons and a daughter. He died on 25 July 1963 at his home in Wimbledon, of a heart attack, aged 67. A memorial service was held in the Chapel of the West London Hospital on 7 August 1963.