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Summary of Significant Accounting Policies - Computation of Unaudited Pro Forma Basic and Diluted Earnings Per Share (Details) - USD ($)
$ / shares in Units, $ in Thousands
3 Months Ended 12 Months Ended
Mar. 31, 2019
Mar. 31, 2018
Dec. 31, 2018
Dec. 31, 2017
Numerator:        
Nett loss attributable to Silk Road Medical, Inc. common stockholders $ (24,158) $ (5,408) $ (37,629) $ (19,356)
Comprehensive loss attributable to Silk Road Medical, Inc. common stockholders (24,158) $ (5,408) (37,629) $ (19,356)
Adjust: Change in fair value of redeemable convertible preferred stock warrants $ 15,712   $ 11,906  
Denominator:        
Weighted average common shares used to compute net loss per share attributable to Silk Road Medical, Inc. common stockholders, basic and diluted (in shares) 1,200,719 739,308 960,882 434,158
Adjust: Conversion of redeemable convertible preferred stock (in shares) 21,233,190   21,233,190  
Adjust: Cash and net exercise of redeemable convertible preferred stock warrants into common stock warrants (in shares) 1,941,105   1,940,450  
Adjust: Cash and net exercise of common stock warrants into common stock (in shares) 5,970   246  
Weighted average common shares used to compute pro forma net loss per share, basic and diluted (in shares) 24,380,984   24,134,768  
Weighted average common shares used to compute pro forma net loss per share, basic and diluted (in shares) 24,380,984   24,134,768  
Pro forma net loss per share, basic and diluted (in USD per share) $ (0.35)   $ (1.07)  
Pro forma net loss per share, basic and diluted (in USD per share) $ (0.35)   $ (1.07)  
Pro forma        
Numerator:        
Nett loss attributable to Silk Road Medical, Inc. common stockholders $ (8,446)   $ (25,723)  
IPO        
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]        
Stock issued, price per share (in USD per share) $ 20.00   $ 20.00