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Surgical hats are for use by those who work in sterile environments, such as during surgical procedures. In addition to wearing other sterile clothing such as nursing scrubs, medical scrubs, scrub coats, and other medical apparel, physicians, nurses, technicians, and others who spend time in the operating room are usually required to wear a head covering that conceals all of their hair. Formerly, the state of the art that was available for hair covering options for those with long hair, particularly women, were limited. The most popular style, the bouffant scrub hat, resembles a shower cap, which can be quite unflattering and bulky. Furthermore, the bouffant falls down on the nape of the neck, which can be uncomfortable and get in the way of a stethoscope, which must be worn around the neck.

Before the introduction of the pony hat, people having short hair had many more desirable options for head coverings than those with long hair. Slim, form-fitting scrub caps that remain off the neck are much more comfortable and flattering, but many women (and men with long hair) were unable to sport these hats due to the shape of the head covering and the inability to conceal all of their hair within it. Recently, there have been many modified head coverings. One of those scrub hats is slim and form-fitted, called the pony hat, and is is flattering, functional, and conceals long hair in a pouch which is held off of the nape of the neck and held in place with a color-coordinated ribbon for style and flare.

Following the pony tail hat, the pixie hat was introduced. The pixie hat is another modified surgical hat, but is a bonnet-style hat which is less bulky and much more flattering than the bouffant hat. The pixie hat was created for those with shorter hair who could not wear the pony hat, but still desired a more flattering approach to the operating room. Both the pony hat and the pixie hat are now available in hundreds of beautiful fabrics, all which coordinate nicely with just about any nursing scrubs or medical scrubs worn in the operating room. The bouffant hat used to dominate the operating room, but the pixie hat and pony hat are now taking over the O.R.

Currently, the most similar hat to the bouffant scrub hat is the poppy hat. The poppy hat is for those with either long or short hair, who prefer the classic look of the operating room uniform, but still want to add a bit of color to their formerly drab wardrobe. The poppy hat, unlike the traditional bouffant hat, has a ribbon which can be hidden or can be used to create a pony-tail. The bouffant hat has been around since women first scrubbed in and will likely be around long after we are gone. The poppy, pixie, pony, and bouffant hats are the four most popular options for women's head covering in sterile conditions.

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