The aim of cardiovascular preoperative evaluation in noncardiac surgery is to assess the current cardiovascular status of patients, to find underlying unknown diseases, to advise about medical management for patients in the preoperative period and, eventually, to postpone noncardiac surgery until cardiac conditions are improved or stabilized. The basic clinical evaluation, obtained by history, physical and ECG examination, provides enough data to estimate the cardiovascular risk. Cardiovascular risk factors and specific surgery risk have a huge importance in this evaluation; the specific surgery risk can be classified into three categories: high, intermediate, and low. However, the evaluation of cardiac risk is not simple and the eventual legal consequences are important. For this reason we propose this hypothesis for an easy approach to a right preoperative assessment based on a succession of eight steps; this way would be a support for specialists and young physicians that are called to give a clinical report on surgery timing and on possible problems of patients with cardiovascular disease undergoing noncardiac surgery.