Surgery is the mainstay of treatment modality for gynecological cancer patients. Surgical treatment for gynecological cancer is offered with the curative intent in early stages of gynecological cancers and also advanced stages of ovarian cancers. The surgical procedures include the complex surgical procedures of radical hysterectomy, retroperitoneal node dissection, and total omentectomy. Surgery for advanced stage ovarian cancer and endometrial cancer may include other procedures of peritoneactomy, modified posterior exenteration, and bowel resection anastomosis. Surgery is performed not only with the intention to cure the diseases but in some instances also for palliative purpose. This chapter covers the history and physical examination, patient workup for diagnosis and disease status evaluation, informed consent and counseling, preoperative workup, optimization of comorbid illnesses, preoperative risk assessment, and nutritional status.