The preoperative evaluationPreoperative evaluation plays a critical role in dermatologic surgeryDermatologic surgery and lays the foundation for safe and high-quality surgical outcomes. Beyond fostering patient rapport, the preoperative evaluationPreoperative evaluation allows the surgeon to anticipate case complexity and adapt the operative plan based on the patient’s presenting lesion, medical and surgical history, medications, and allergies. A standardized intake form can streamline the preoperative evaluationPreoperative evaluation; however, each patient’s unique medical history should be discussed in detail. Special consideration is warranted for cardiac conditions, permanent pacemakers, and implantable cardioverter defibrillatorsDefibrillators, which may require precautions when employing electrosurgical techniques. While anticoagulantsAnticoagulants such as warfarin and newer oral anticoagulantsAnticoagulants may increase the incidence of local bleedingBleedingcomplicationsComplications, interrupting these medications during the perioperative period poses a severe risk of potentially life-threatening thromboembolic events. Therefore, therapeutic anticoagulantsAnticoagulants and cardiac medications, including beta-blockers, are typically continued throughout the perioperative period. Preoperative antibiotics are generally limited given the very low risk of bacteremia from dermatologic surgeryDermatologic surgery. The American Heart Association guidelines recommend limiting prophylactic antibiotics to patients with cardiac conditions at highest risk for endocarditis undergoing surgery with breach of the oral mucosa or on infected cutaneousCutaneous sites.