Traditionally seen as being at the heart of all diagnostic evaluations, the History and Physical is both an art and science. This lecture will review the basic format for obtaining a complete history, followed by key elements of a thorough physical exam. This will be done with an emphasis on effective evaluation of the 'at risk' medical patient, through the eyes of a Family Physician. For some, it will be a review of skills already acquired while others will learn new techniques. Hopefully everyone will gain a better appreciation and enhanced confidence of the pre-operative medical clearance.