There exists a significant disparity in the availability of vascular services between high and low- to middle-income countries. The Global Vascular Companionship seeks to address this disparity through provision of vascular training of surgeons to provide these services to their respective nations. Local capacity building can take a number of forms. We present two possible models for this. Firstly, a surgeon who has completed a formal vascular fellowship at a recognised institution may still feel unable to provide the full scope of care that their nation may require. This surgeon and nation may be assisted by outreach visits from vascular surgeons to provide additional training in defined paradigms and procedures, to expand the services available locally. Secondly, a surgeon who may not require a formal fellowship in vascular surgery, either due to local experience or circumstances, could avail of similar outreach visits to upskill both themselves and their institutional staff in certain aspects of vascular care. Insight into an individual's skillset and local infrastructure is key in identifying what degree of training can occur locally. An overarching Global Vascular Curriculum, with core and non-core modules, could assist in providing a framework for such training. On-site vascular training in low- and middle-income countries, either to refine or develop new skills in the provision of vascular care, is a key step in allowing each person, in every nation, to access to equitable vascular care.