When conducting a preoperative evaluation of a patient with vascular disease, it is crucial to compile a detailed history and perform a thorough physical examination. One must assess for other comorbidities as well as the extent of the disease, as patients with vascular disease often have coexisting ischemic heart disease, hypertension, cerebrovascular disease, or chronic renal insufficiency. The goal of the preoperative evaluation is to identify modifiable risk factors, coordinate a treatment plan with other members of the perioperative care team, and optimize the patient’s medical condition to shift the balance of risk/benefit ratio before proceeding with nonemergent surgery.