Perioperative hypersensitivity reactions pose a complex clinical problem. The combination of surgical intervention, the simultaneous action of several drugs, including anesthesia, and comorbidity of the patient complicates the assessment of perioperative urgent events. To date, there are no clear international and national recommendations on standardized preoperative examinations of patients to prevent drug allergies. The article presents modern data on the mechanisms of causes and the possibility of preventing perioperative allergic reactions.