A third of the 15 surgeons employed at Royal Darwin Hospital have quit over pay and conditions.

The ABC understands four general surgeons have tendered their resignation in the past couple of days.

Of the remaining surgeons at the hospital, at least one and possibly two are also likely to give notice.

The Health Department and the surgeons have been negotiating pay and conditions for 15 months.

Surgeons say their pay is 25 to 30 per cent lower than in other jurisdictions.

The department has not been able to replace a surgeon who left in January this year.

An urgent meeting will be held in the next few days in an attempt to resolve the dispute.

Surgeons say the only way left for them to express their concern is to resign.

They have agreed to see out their periods of notice, which range from two weeks to three months.

The hospital's Acting General Manager, Alan Wilson, says he is hoping the surgeons will return.

Mr Wilson says the mass resignation will cause major disruptions to the hospital's elective surgery schedule.

But he is confident emergency and acute procedures can continue.