The present invention relates to a contoured scalpel handle. The contoured shape of the handle provides for increased contact area with the user's hand using a larger diameter central portion and a smaller diameter trough. The generally circular cross-section allows rotation of the angle of the blade relative to the tissue without the need to change the grip on the handle. The contoured handle can be used as an adapter sleeve in which a scalpel handle can be inserted or can include a blade mounting element on which a blade is directly mounted.