The preoperative evaluation of patients undergoing cardiac surgery constitutes a fundamental component of perioperative management and significantly influences the overall course of hospitalization. This chapter outlines the multidisciplinary approach required for optimal assessment, integrating the essential elements of: Through systematic clinical evaluation, it becomes possible to achieve accurate risk stratification and prognostic assessment, thereby enabling the formulation of an individualized anesthetic and surgical plan that minimizes perioperative risk and optimizes patient outcomes.