Background Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. Methods Near-peer teaching rounds consisted of senior student–precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student–preceptors. Results The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤.001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student–preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. Conclusions Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student–preceptors gained early experience for careers in academic surgery.