Complex surgeries are one of the most frequently used therapies performed in the treatment of primary as well as recurrent gynecologic malignancies. In addition to improving tumor control and overall prognosis, further aspects, such as treatment-related morbidity and quality of life, are crucial for cancer treatment. Perioperative management is an integral part of the surgical treatment. Multimodal pathways to prepare patients for surgery, minimize the stressors during the operation, and ensure optimal recovery are key factors to reduce complications and improve outcomes. Therefore, scientific interest in perioperative management has increased in the last few years.