Cancer surgery is associated with adverse effects and major metabolic stress that causes loss of lean muscle mass contributing to reduced physical function, homeostatic instability, limits aerobic capacity and can negatively impact the quality of life (1, 2). Exercise therapy has been shown to have a positive outcome in attenuating treatment-related adverse effects. In general, exercise has been limited to the post-surgical period, however, due to patient anxiety and other underlying conditions such as fatigue and additional treatments, this time may not be favourable for high-risk surgical populations. Muscle catabolism due to the stress response to surgery, immobility, and pain results in a reduction in physical function and places surgical patients at significant risk for poor surgical recovery. A more opportune time to intervene with exercise may be the pre-surgical period to negate or attenuate treatment-related adverse effects thereby aiding recovery from surgery and enhancing short- and long-term patient outcomes (3). Studies to date in patients scheduled for surgery indicate that presurgical exercise leads to a superior and faster return to baseline physical function levels, higher pain thresholds and reduced length of hospital stay (4). The aim of this presentation is to provide an overview of current evidence for the clinical utility of presurgical exercise therapy as well as practical considerations for prescribing exercise in the preoperative surgery setting.