Abstract: The major adverse cardiac event (MACE) in patients undergoing noncardiac surgery is associated with a marked increase in morbidity and mortality. It is critical to use appropriate assessment tools preoperatively to assess the risk of major adverse cardiac event in patients undergoing noncardiac surgery. We already have guidelines and expert consensus to guide the risk stratification for perioperative major adverse cardiac events in patients undergoing noncardiac surgery. Revised Cardiac Risk Index, the American College of Surgeons' National Surgical Quality Improvement Program Myocardial Infarction or Cardiac Arrest Risk Calculator, and the American College of Surgeons' National Surgical Quality Improvement Program Surgical Risk Calculator are currently common assessment tools used for perioperative major adverse cardiac events in patients undergoing noncardiac surgery. Currently, we have no relevant research on analyzing the applicable conditions, evaluating the merits and demerits of those assessment tools, and comparing the predictive values on perioperative major adverse cardiac events in patients undergoing noncardiac surgery. In this article, we review some domestic and foreign literature in recent years, attempting to summarize the performance of these assessment toolsin patients undergoing noncardiac surgery. We also aim to provide a guide for doctors to find the most optimal preoperative assessment tool.