ABSTRACT Background: Patients with peripheral arterial disease have an increased risk of developing cardiovascular complications in the postoperative period of arterial surgeries known as Major Adverse Cardiac Events (MACE), which includes acute myocardial infarction, heart failure, malignant arrhythmias, and stroke. The preoperative evaluation aims to reduce mortality and the risk of MACE. However, there is no standardized approach to performing them. The aim of this study was to compare the preoperative evaluation conducted by general practitioners with those performed by cardiologists. Methods: This is a retrospective analysis of medical records of patients who underwent elective arterial surgeries from January 2016 to December 2020 at a tertiary hospital in São Paulo, Brazil. The authors compared the preoperative evaluation of these patients according to the initial evaluator (general practitioners vs. cardiologists), assessing patients’ clinical factors, mortality, postoperative MACE incidence, rate of requested non-invasive stratification tests, length of hospital stay, among others. Results: 281 patients were evaluated: 169 assessed by cardiologists and 112 by general practitioners. Cardiologists requested more non-invasive stratification tests (40.8%) compared to general practitioners (9%) (p < 0.001), with no impact on mortality (8.8% versus 10.7%; p = 0.609) and postoperative MACE incidence (10.6% versus 6.2%; p = 0.209). The total length of hospital stay was longer in the cardiologist group (17.27 versus 11.79 days; p < 0.001). Conclusion: The increased request for exams didn’t have a significant impact on mortality and postoperative MACE incidence, but prolonged the total length of hospital stay. Health managers should consider these findings and ensure appropriate utilization of human and financial resources. Background MACE, , (MACE) infarction failure arrhythmias stroke However them Methods 201 202 Paulo Brazil vs cardiologists, cardiologists) factors noninvasive non invasive others Results 28 evaluated 16 11 40.8% 408 40 8 (40.8% 9% 9 (9% 0.001, 0001 0.001 0 001 0.001) 8.8% 88 (8.8 10.7% 107 10 7 0.609 0609 609 10.6% 106 6 (10.6 6.2% 62 2 0.209. 0209 0.209 . 209 0.209) 17.27 1727 17 27 (17.2 1179 79 11.7 days 0.001. Conclusion didnt didn t resources (MACE 20 1 40.8 4 (40.8 (9 000 0.00 00 8.8 (8. 10.7 0.60 060 60 10.6 (10. 6.2 020 0.20 17.2 172 (17. 117 11. 40. (40. ( 0.0 8. (8 10. 0.6 06 (10 6. 02 0.2 17. (17 (40 0. (1 (4