The length of hospital stay shortens increasingly. Even more patients are assessed and clarified in the outpatient clinic. Preoperative evaluation is performed ambulatory or by the general practitioner himself. There is still a trend towards fewer and more selective examinations. The value of evaluation algorithms is subject of debate nowadays. Moreover, these extensive and abstract procedures are not always helpful in clinical practice. The perioperative cardioprotection with beta-blockers and statins and the continuation of antiplatelet therapy seems to have significance in reduction of perioperative cardiac events. However, a careful physical examination and a precise medical history of the patient have not become less important today. They contribute significantly to an efficient preoperative evaluation.