Aim: This manuscript describes implementation of clinical decision support for providers concerned with perioperative complications of malignant hyperthermia susceptibility. Materials & methods: Clinical decision support for malignant hyperthermia susceptibilit was implemented in 2018 based around our preemptive genotyping platform. We completed a brief descriptive review of patients who underwent preemptive testing, focused particularly on RYR1 and CACNA1S genes. Results: To date, we have completed preemptive genetic testing on more than 10,000 patients; 13 patients having been identified as a carrier of a pathogenic or likely pathogenic variant of RYR1 or CACNA1S. Conclusion: An alert system for malignant hyperthermia susceptibilit – as an extension of our preemptive genomics platform – was implemented successfully. Implementation strategies and lessons learned are discussed herein.