Surrogacy is fraught with legal risks. Medical opinion on surrogate parenting ranges from outright advocacy to harsh condemnation. As a legal matter, physicians have no duty to participate in surrogacy arrangements and may violate the law by doing so in some states. The core recommendations from this guide are reproduced here. Physicians who choose to participate in surrogacy should carefully consider these recommendations. If they choose to deviate from them, the reason for this deviation should be discussed in the medical record.