Failure to account for all sponges, sharps, and instruments postoperatively may lead to the inadvertent retention of a foreign object. The retention of a foreign object may cause serious patient harm and often requires further medical treatment. Surgeons and operating teams routinely rely on the practice of a sponge, sharp, and instrument count to reduce the risk of a retained foreign object. Surgical counts are intended to prevent the retention of a sponge, sharp, or instrument, yet despite the highly regulated nature of the process, discrepancies in the surgical count occur. Preventing retained foreign objects requires a multipronged strategy, including reliable counting methods. However, counting alone may be insufficient.