Patients with cardiovascular diseases are at high risk for thoracic surgery, and the preoperative risk evaluation and management is usually difficult. In 2014, the authority organization American Heart Association(AHA)/American College of Cardiology(ACC) and European Society of Cardiology(ESC)/European Society of Anaesthesiology(ESA) published new guidelines respectively on cardiovascular assessment and management for non-cardiac surgery and introduced a number of recommendations in the field. The article aims to comment on the two guidelines based on the clinical practice experience in Shanghai Chest Hospital in order to give some recommendations on preoperative evaluation at two aspects. First, it is aimed to identify patients for whom the perioperative period may constitute an increased risk of morbidity and mortality, aside from the risks associated with the underlying disease. Second, it may help to design perioperative strategies to reduce additional perioperative risks.