Introduction: Honorary authorship (HA) is defined as an enlisted co-author who did not make sufficient contributions to merit being included as a co-author according to the ICMJE guidelines on authorship. It is unknown if HA is present in the surgical literature. Methods: We analysed studies published in 2016 in five journals with the highest impact factor in general surgery. All original articles, reviews and clinical trials with more than one author were included. Corresponding authors of these manuscripts received an online survey by email. The survey consisted of three parts focussing on demographics, knowledge and application of the ICMJE guidelines, and deciding authorship. Results: In total, 320 of the 1037 surveys were completed (30.9%). Two hundred and seventy-two (88.6%) of the corresponding authors were aware of the ICMJE authorship guidelines, and 203 (66.3%) were aware of the general issue of honorary authorship. One hundred and thirty-five (44.0%) responders reported at least one co-author who only performed tasks which should not merit actual authorship according to the ICMJE guidelines. Furthermore, only 46 (15.0%) of the responders believed that a co-author listed for their article did not make sufficient contribution to merit being included as co-author. No significant differences were found between the journals investigated. Conclusion: Despite ICMJE guidelines to reduce HA, the prevalence may still exist to a higher level than preferable. The authors plead for more transparent authorship systems in which journal editors and senior department members take more responsibility into enforcement of the ICMJE guidelines.