Widmer RJ, et al. - Current guidelines support the use of dobutamine stress echocardiography (DSE) prior to non-cardiac surgery in higher risk patients who are unable to perform at least 4 metabolic equivalents of physical activity. Herein, post-operative outcomes were assessed in patients falling in different operative risk categories who had pre-operative DSE. In these patients, low cardiac event rates were reported. Notably, previously accepted construct of low, intermediate and high risk surgeries based on postoperative events of <1%, 1-5%, and > 5% overestimates the actual risk in contemporary settings.