Cardiac complications are a major cause of perioperative morbidity and mortality. These are caused by either myocardial ischaemia or acute coronary thrombosis. The preoperative assessment aims to collect information on the extent and the stability of the cardiovascular disease in order to predict the patient's risk for developing perioperative cardiac complications. This assessment allows measures to be taken that aim to reduce such risks. The present review summarizes the current state of knowledge on the preoperative assessment of the cardiac patient scheduled for noncardiac surgery.