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Preoperative evaluation of patients being considered for pulmonary resection is a common practice for both pulmonologists and internists. Traditionally, preoperative evaluation of this population has entailed identifying patients in whom pulmonary resection carries an unacceptably high risk of morbidity and mortality. However, recent advances in surgical technique and patient management have prompted a reconsideration of traditional preoperative approaches. This article reviews procedures currently used in the preoperative evaluation of patients considered for pulmonary resection, including the patient history, physical examination, and preoperative interventions, and addresses further evaluation of the high-risk patient.