BACKGROUND : The US continues to be in the midst of an opioid epidemic. The prescription of narcotics for acute injury or post-operative pain is a common inciting event leading to opioid abuse and addiction. It is eminently important for orthopedic surgeons to lead the charge in changing practice patterns to decrease the prescribing and subsequent use and abuse of opioids. Anecdotally, many surgeons are aware that use of opioids for post-operative pain is substantially less in other countries compared to the US. However, this has not been well quantified and may be useful information to guide practice. METHODS : The 2018 American Orthopedic Association (AOA)- Japanese Orthopedic Association (JOA) traveling fellows developed a survey to compare orthopedic surgeon-reported opioid prescribing patterns after various common orthopedic surgeries in Japan and the US. RESULTS : We present here survey data demonstrating significantly less post-operative prescription of opioids in Japan in terms of number of pills provided and duration of prescriptions compared to orthopedic surgeons in the US. CONCLUSIONS : We hope this provides meaningful data to motivate orthopedic surgeons in the US to evaluate and potentially alter their own prescription habits to help mitigate the opioid crisis.