Roshal has been leading the Emergency Surgery & Children's Trauma Department of Moscow's Pediatric Scientific Research Institute since 1981. In 2003, he also took over the Moscow Institute of Emergency Children's Surgery & Traumatology, which is currently treating 60,000 children a year.
Dr. Roshal negotiated with Chechen terrorists during the Moscow theater hostage crisis in 2002. He also served as a negotiator in the 2004 Beslan school hostage crisis, working for the release of children and trying to convince the hostage-takers to allow the hostages to have food and water. After the events in the Beslan crisis played out, he also served as the advisor to the medical teams that had to treat burn wounds on hundreds of children.
Since 2005 he is a member of the Public Chamber of Russia.
In February 2006 he criticized the Mothers of Beslan for "judge[ing] the state rather than the terrorists" at a trial of one of the Beslan hostage takers.