The number of surgeries performed for the elderly and senile persons with concomitant cardiovascular pathology is increasing every year. It is in this category of patients that the likelihood of developing perioperative cardiac complications is highest, which requires the use of cardioprotective measures to reduce the risk of their occurrence. One of the options for cardioprotection may be the use of drugs aimed at improving metabolism and maintaining adequate energy supply to the myocardium. Such metabolic agent is exogenous phosphocreatine. This article provides an overview of studies on the use of exogenous phosphocreatine as a cardioprotector in patients undergoing noncardiac surgery. The publications were searched for in PubMed / Medline, Embase, e-library, China National Knowledge Infrastructure, WANGFANG DATA. It has been shown that the use of phosphocreatine (PhC) in abdominal surgery, oncosurgery, during operations in traumatology, thoracic surgery, transplantation, as well as in intensive care units for sepsis and septic shock is associated with a decrease in the risk of cardiac complications and a reduction in mortality. Considering the above data on the positive cardioprotective effect of exogenous phosphocreatine in various surgeries, this protective agent can be recommended for wider application in clinical practice, especially in patients with high cardiac risk.