Aim - to determine the prevalence and risk factors for cardiovascular events (CVE) in elective abdominal surgery taking into account the history, laboratory and instrumental data. Material and methods. The study involved 179 patients with confirmed cardiovascular diagnosis and/or older 65 years before elective abdominal surgery. Cardiologist’s consultation, laboratory tests, ECG, transthoracic echocardiography, Holter ECG and ergospirometry (ESM) were performed. Cardiovascular complications were recorded within 30 days after surgery. Results. The incidence of major and fatal cardiac events was 6.7 and 5.6% respectively. Patients with CVE had lower preoperative levels of hemoglobin (100 g/l vs 128 g/l; p=0.001), higher creatinine level (p=0.007), more frequent ECG-abnormalities (93% vs 72%; p=0.011), lower ejection fraction (56.5% vs 60.0%; p=0.03), velocity time integral in LV outflow tract (VTI) (19.5 cm vs 21.7 cm; p<0.01) and global longitudinal left ventricular strain (–17.8 vs –18.0; p=0.049). There were higher augmentation of heart rate within 1 minute of exersize (30.0% vs 21.4%; p=0.003), lower peak oxygen consumption (16.3 ml/kg/min vs 18.0 ml/kg/min; p=0.032) and oxygen consumption at the anaerobic threshold level (11.2 ml/kg/min vs 14.1 ml/kg/min; p=0.022) in CVE patients. Conclusion. Preoperative echocardiography with assessment of left ventricular longitudinal strain and ergospirometry are advisable to clarify the risk of cardiovascular complications in elective abdominal surgery in elderly patients and/or with cardiovascular anamnesis.