Background and Objectives: Cardiovascular diseases (CVDs) are the leading cause of global morbidity and mortality, and significantly influence perioperative risk in non-cardiac surgery. This study aimed to evaluate the prevalence of cardiovascular comorbidities and their immediate impact on perioperative management in a tertiary surgical center. Materials and Methods: A retrospective cohort study was conducted including all adult patients undergoing elective or emergency non-cardiac surgery between January 2022 and December 2024. Demographic data, primary diagnoses, cardiovascular comorbidities, chronic medication, and perioperative management modifications were analyzed. Descriptive statistical analysis was performed using SPSS v16. Results: A total of 5716 patients were included. Cardiovascular comorbidities were identified in 2157 patients (37.37%). Hypertension (HTN) was the most prevalent condition (33.37%). Surgical delay due to anticoagulation occurred in 4.16% of cases, postponement due to cardiovascular instability in 1.27%, and surgery was contraindicated in 0.50%. Conclusions: Cardiovascular comorbidities are highly prevalent among patients undergoing non-cardiac surgery and frequently require modification of perioperative management strategies. Further studies incorporating postoperative outcomes are needed to better define their impact on surgical prognosis. Structured cardiovascular risk assessment aligned with ESC (European Society of Cardiology) guidelines appears clinically justified, although future outcome-based studies are required.