The purpose of this literature review is to examine current evidence and determine the effects of stress hyperglycemia on patient outcomes during the perioperative period. This review summarizes the pathophysiology of stress hyperglycemia, the population it affects, and strategies for optimal treatment to reduce the potential for postoperative complications. A literature search produced 16 of the most current studies on the effect of stress hyperglycemia in both the diabetic and nondiabetic populations. The evidence presented indicates the need to maintain tight glucose control in the perioperative patient. Although there are varying approaches to managing stress hyperglycemia, there is compelling agreement that stress hyperglycemia should be treated in all surgical patients.