Artificial intelligence (AI) is driving transformation across many fields, and surgery is no exception. Numerous examples have shown that health AI can improve decision making, prevent harm, and reduce spending. Despite this, real-world applications of AI in surgery remain limited. A key barrier is the lack of a common language between surgeons and those developing AI. Moreover, concerns exist that AI will depersonalise healthcare, impair training, and have negative impacts on our healthcare ecosystem. It is not surprising then that in Australia and New Zealand (ANZ), health authorities advocate caution against the use of AI or have yet to develop guidelines. Nevertheless, given the heavy utilisation of technology and imaging in our field, Vascular Surgeons are particularly well-positioned to adopt AI. The Royal Australasian College of Surgeons (RACS) Surgical Competence and Performance Framework is an established structure within which surgical training in ANZ is facilitated. In this narrative review, we use the RACS competencies as a lens to discuss AI as a tool for the Vascular Surgeon. A thematic search was performed to identify papers using the PubMed, EMBASE, PsychInfo, and Google Scholar databases, and appraised within the RACS competencies. Papers were included based on their relevance, and excluded if they were non-peer-reviewed, non-English, or non-contemporaneous. This presentation will provide an overview of the core concepts and applications of AI in surgery, alongside a discussion on the risks of AI to health. Judicious and ethical adaptation of AI is of benefit to patients and may increase the efficiency and sustainability of a lean workforce, but requires the contemporary Vascular Surgeon to understand and lead its responsible implementation.