Effective pre-operative assessment improves patient outcomes by ensuring that individuals are adequately prepared for anaesthesia, surgery and the post-operative period. It can also improve hospital efficiency by reducing patient waiting times and enabling early discharge. Nurse-led pre-operative assessment for elective surgery is becoming increasingly recognised as a valuable method of ensuring that patients have a safe and well-planned hospital stay. This article examines the role of the pre-operative assessment nurse within a nurse-led service for elective surgery at a district general hospital.