(1) The goals of preoperative assessment are to reduce surgery-related morbidity, improve perioperative care quality, and decrease costs. (2) A thorough history and physical exam are important for perioperative risk assessment to identify conditions affecting risk. Key factors include cardiac disease, frailty, comorbidities, and surgery/anesthesia details. (3) Based on initial evaluation, further tests may be needed but routine lab testing is unnecessary. Indicated tests depend on individual history and symptoms. Overall risk prediction considers age, surgery invasiveness, organ function, and disease control to guide management.