The primary care team has an integral role in the risk assessment of patients undergoing non-cardiac surgery. The risks of non-cardiac surgery are most frequently due to coronary artery disease and impaired cardiac function, as well as other medical conditions. Perioperative risks can be eliminated or reduced if they are predicted pre-operatively and appropriate measures taken. The aim of risk assessment is to prevent or reduce peri-operative risk. Some risk factors may be correctable. Peri-operative risk depends on the: type of procedure to be performed; patient's risk profile; and experience and quality of the medical team and hospital facilities. A thorough clinical history and examination is important, and provides a fairly accurate estimation of peri-operative risk. All patients with known or suspected heart disease should be evaluated for the presence of heart failure, coronary artery disease, arrhythmia and previous myocardial infarction.