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When Thomas Wakley founded The Lancet in 1823, he announced "A lancet can be an arched window to let in the light or it can be a sharp surgical instrument to cut out the dross and I intend to use it in both senses". This philosophy remains at the heart of the journal today.

The Lancet first appeared on Oct 5, 1823. From the beginning, Wakley's aim was to entertain, instruct, and reform. Instruction came in the form of transcribed medical lectures from the London teaching establishment; entertainment in the early days of the journal came in the form of theatre reviews and piquant political comment. The Lancet has been, first and foremost, a reformist medical newspaper. Thomas Wakley and his successors aimed to combine publication of the best medical science in the world with a zeal to counter the forces that undermine the values of medicine, be they political, social, or commercial.

The journal was, and remains, independent, without affiliation to a medical or scientific organisation. More than 180 years later, The Lancet is an independent and authoritative voice in global medicine. We seek to publish high-quality clinical trials that will alter medical practice; our commitment to international health ensures that research and analysis from all regions of the world is widely covered. Critical appraisal of research and reviews is ensured by strong Comment and Correspondence sections; The Lancet's opinion and personality is communicated by three editorials every week; fast dissemination of priority issues is delivered by early online publication through thelancet.com; and the continued success of our monthly specialty titles ensures that The Lancet delivers in-depth knowledge in key medical disciplines .