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Perioperative cardiac arrest: a rare event worth measuring. Perioperative cardiac arrest remains a rare but devastating event, particularly among emergency surgery patients. Work by Anezaki and colleagues confirms that emergency and elective populations represent distinct patient groups requiring different care pathways. Anaesthetists should consider patient- and procedure-level factors to anticipate and mitigate risk, while embracing upstream prevention and strengthening perioperative systems. Healthcare systems must focus on reducing variation in care between institutions to improve overall outcomes.