In many pathology departments, some cases are reviewed routinely by a second pathologist within the same department before sign-out. The value of this practice is not known. This study reviewed and compared the disagreement and amendment rates for cases reviewed by 1 or more pathologists based on the results of blind review. A total of 4,181 cases underwent blind review, and of these, 543 [13.0%] were reviewed by more than 1 pathologist before sign-out. The disagreement rate for cases reviewed by more than 1 pathologist was 4.8% and this was significantly lower than for cases reviewed by only 1 pathologist which was 6.9% [P=0.004]. The amendment rate was 0.0% and 0.5%, respectively, but this difference was not statistically significant [P=0.12]. Review of material by a second pathologist before sign-out is associated with a lower disagreement rate. These results suggest that second review of surgical pathology is of value, but the best selection of cases to be reviewed remains to be defined.