Recently, the American College of Gastroenterology (ACG) released the clinical guidelines on perioperative risk assessment and management of patients with cirrhosis, proposing a comprehensive approach for perioperative risk assessment and management in these patients. The guidelines mainly focus on the severity of liver diseases, extrahepatic comorbidities, and surgery-specific factors, with an emphasis on individualized risk stratification using validated risk assessment tools (such as the VOCAL-Penn score) for patients with cirrhosis. This article gives an excerpt of the key statements in the guidelines.