Preoperative Patient Preparation, Programs, and Education in the United States State of the Art, State of the Science, and State of Affairs Solomon Aronson, MD, MBA, FCCP a, * , Mike P.W. Grocott, BSc, MBBS, MD, FRCA, FRCP, FFICM b , Michael (Monty) G. Mythen, MD c a Anesthesiology and Population Health Science, Duke University School of Medicine, DUMC 3094, MS 33, 103 Baker House, Durham, NC 27710, USA; b University Southampton, University Road, South Hampton SO17 1BJ, UK; c University College London, 170 Tottenham Court Road, London W1T 7HA, UK Statement of Commercial or Financial Conflicts and Funding Sources: S. Aronson, M.P.W. Grocott, M.G. Mythen have positions on the board of directors for the International Board of Perioperative Medicine (IBPOM). S. Aronson serves on the medical advisory board for Summus Global Inc. M.P.W. Grocott serves on the medical advisory board of Sphere Medical Ltd, NIHR Senior investigator. M.G. Mythen consults for Edwards life Sciences. Keywords  Perioperative medicine  Perioperative education  Preoperative assessment  Surgery Key points  We describe the state of the art for clinical preoperative patient preparation programs in the United States and give examples.  We describe the state of the science for preoperative patient preparation process utilized in United States and United Kingdom and provide evidence to support best practice.  We describe the state of the affairs for perioperative education in the United States and broader international Anesthesia community and provide examples of noteworthy programmatic education. *Corresponding author. E-mail address: solomon.aronson@duke.edu https://doi.org/10.1016/j.aan.2019.08.005 0737-6146/19/Crown Copyright ª 2019 Published by Elsevier Inc. All rights reserved. Advances in Anesthesia 37 (2019) 127–143 ADVANCES IN ANESTHESIA