Aims: To determine the number and distribution of surgical anaesthesia and obstetric (SAO) care providers (both qualified and practitioners); and to establish the patient SAO care provider ratio in Somalia. Methods: Cross-sectional study design using quantitative data. The study was conducted in health facilities of 2 Administrative zones of Somalia (Northeast known as Puntland and South/central). The Surgical Assessment Tool (SAT). Results: 55 health facilities participated. The results indicate that most of the SAO providers were in the Benadir state (57%) (Puntland (13%), Southwest (10%), Galmudug (8%), Jubaland (7%), and Hirshbelle(5%)). Most SAO providers were midwives (309) (MBBS providing surgery 127, nurse anaesthesia 89, foreign provider 82, consultant surgeon 67, O&G consultant 54, MBBS providing anaesthesia 49, biomedical 34, orthopaedic consultant 26). Other SAO providers were consultants from the following specialities: radiology, ENT, anaesthesia, and ophthalmology, urology, pathology, neurosurgery, cardiothoracic, cardiology and paediatric surgery. Finally, there was no consultant SAO providers from the following specialities: oncology, gastroenterology, or paediatric anaesthesia. The highest number of SAO providers worked in urban areas (874), whilst rural SAO providers numbered 75. All the states in Somalia had a lower SAO provider: population than the goal of 20 SAO providers for every 100,000 persons set by the Lancet Commission on Global Surgery. Benadir had the highest SAO provider: population (16:100000) followed by Puntland (7:100000), Jubaland (5:100000), Hirshebelle, and Galmudug (3:100000) and South West (2:100000). It is worth noting that the Benadir region is  a capital, Mogadishu. The national average was 6:100000. The actual number of health employees (of all types) in Somalia is unknown. Conclusions: This study demonstrates that there is a deficiency in Somalias SAO workforce and that it is still a neglected topic. Currently, the workforce required to meet the needs of the population is not present.