We examined changes in performance as people learned to use an angled laparoscope, a challenging spatial skill that must be mastered by surgeons who perform minimally invasive techniques. In Experiment 1, novices took tests of spatial and general reasoning ability, and then learned to operate an angled laparoscope, simulated in a virtual environment, over 12 learning sessions. Initial performance showed considerable variability among learners, with performance related to general and spatial abilities. As learning progressed, interindividual variability diminished and all learners attained proficiency; the correlation with general ability diminished but the correlation with spatial ability remained significant. In Experiment 2, performance by highly experienced surgeons on the simulation was excellent from the first session, confirming its ecological validity. The findings contribute to theories of skill acquisition. They also have practical implications for the selection of surgeons and for the potential use of virtual environments in surgical training.