Retrospective analysis has been carried out with the surgical material of 9 years in the wards of surgical character of a county hospital to determine the incidence and main clinical characteristics of perioperative myocardial infarction. Data of 61 patients were processed in order to answer the questions. Age, arteriosclerosis causing disturbance of organ perfusion and the change of blood pressure in the perioperative period play the main role in the development of this complication of high mortality. Detailed clarification of the coronary state before the elective operation, a possible aortocoronary bypass operation appear to prevent most effectively the pathological picture.