AIM OF THE STUDY: The aim of the study was lo considerate the effective usefulness of preoperative stress test and echocardiography in adult patients with coronary artery disease, undergoing non-cardiac surgery. MATERIALS AND METHODS: In the last three years, 200 patients aged 58-85, affected by stable ischemic pathology, undergoing non cardiac surgery, and treated with oral drugs, were enrolled for an assessment orotocol including anamnesis, objective examination, blood pressure, RCG, blood chemistry analysis, and was performed a cardiac risk evaluation. A second 50 patients control cohort of the same class was subjected to the same tests, and preoperative and exercise stress test. RESULTS: All patients showed a good hemodynamic compensation and a quick recovery, and the group of 200 patients for whom the risk was closed without further investigation has concluded the process on average three days before the group underwent echocardiography and exercise stress test. DISCUSSION: The clinical evaluation of cardiac patients waiting for non-cardiac surgery, performed through anamnesis, examinations and the ECGs, is the cornerstone of cardiac risk stratification. It also important the type of surgery, as well as some priority conditions like certain neoplastic: diseases, where it seems appropriate to speed up the diagnostic program. CONCLUSIONS: When patients are hemodynamically stable and their conditions controlled by appropriate therapy, it is sufficient to perform first-level tests for the preoperative stratification of cardiovascular risk. It’s recommended to perform echocardiogram and stress test when the first level tests are abnormal, when there is a worsening of the conditions prior to admission, or when the patient is not hemodynamically stable.